title: Jejunal limb obstruction caused by a cholesterol stone 15 years after a total gastrectomy and 20 years after a cholecystectomy: report of a case.
abstract: We present herein the rare case of a 74-year-old woman found to have jejunal limb obstruction caused by a cholesterol stone 15 years after a total gastrectomy with Roux-en-Y anastomosis, and 20 years after a cholecystectomy. The patient complained of repeated episodes of upper abdominal distress on three separate occasions over a period of 20 months, and jejunal limb obstruction was diagnosed by abdominal computed tomography scanning and (99m)Tc scintigraphy. Surgery revealed a stone incarcerated in the jejunal limb, where the anastomosis had become slightly stenotic. The removed stone was 3.5 cm in diameter and was subsequently demonstrated to be a cholesterol stone by chemical analysis. This report is thought to be the first to describe jejunal limb obstruction caused by a gallstone incarcerated in the jejunal limb after a total gastrectomy in a patient with a history of cholecystectomy.
authors.affiliation: Department of Surgery, Kasumigaura National Hospital, 2-7-14 Shimo-Takatsu, Tsuchiura-shi, Ibaragi 300-0812, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Wada
authors.forename: M
authors.initials: M
authors.lastname: Seki
authors.forename: Y
authors.initials: Y
authors.lastname: Saikawa
authors.forename: M
authors.initials: M
authors.lastname: Satoh
authors.forename: A
authors.initials: A
authors.lastname: Toizumi
authors.forename: Y
authors.initials: Y
authors.lastname: Tamura
authors.forename: T
authors.initials: T
authors.lastname: Kageyama
authors.forename: Y
authors.initials: Y
authors.lastname: Otani
authors.forename: T
authors.initials: T
authors.lastname: Kubota
authors.forename: K
authors.initials: K
authors.lastname: Kumai
authors.forename: M
authors.initials: M
authors.lastname: Kitajima
mesh_terms: D000208:Acute Disease; D000343:Afferent Loop Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D000368:Aged; D000681:Amylases / Q000097:blood; D000713:Anastomosis, Roux-en-Y; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000150:complications* / Q000601:surgery; D002784:Cholesterol; D004766:Enterostomy; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007813:Laparotomy; D010195:Pancreatitis / Q000175:diagnosis / Q000201:enzymology / Q000209:etiology; D013667:Technetium; D014057:Tomography, X-Ray Computed
chemical_list: D013667:Technetium; D002784:Cholesterol; D000681:Amylases