[Ischaemic stump necrosis after subtotal gastric resection - a rare complication].
The development of gastric stump necrosis after subtotal gastrectomy with Roux-en-Y loop reconstruction and splenectomy in a patient with gastric cancer is described. The patient's life could be saved by re-operations on the 12th and 50th postoperative day. Due to the patient's poor general condition and local peritonitis the gastric stump was removed and a catheter-jejunostomy was prepared by using the Roux-en-Y loop. The aboral end of the oesophagus was closed. To relieve the oesophageal stump a cervical mucoso-oesophagostoma was carried out. As the patient's general condition improved the reconstruction of the alimentary tract was performed by preparing a new Roux-en-Y loop oesophago-jejunostomy and by closing the mucoso-oesophagostoma.9 years after the operation the patient died of pulmonary metastases. The reasons for the delayed re-operation and the advantages of the cervical mucoso-oesophagostoma are explained.
Szûcs
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Allgemeinchirurgische und Thoraxchirurgische Abteilung, Semmelweis Krankenhaus, Miskolc, Ungarn.
Tóth
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I
D000230:Adenocarcinoma / Q000601:surgery; D000713:Anastomosis, Roux-en-Y; D000714:Anastomosis, Surgical; D004947:Esophagus / Q000601:surgery*; D005500:Follow-Up Studies; D005743:Gastrectomy; D018530:Gastric Stump / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011859:Radiography; D013274:Stomach Neoplasms / Q000601:surgery; D013997:Time Factors