Duodenal obstruction by gallstone in the absence of cholecystoenteric fistula, an unusual complication of total gastrectomy: report of a case.
We present a case of gallstone obstruction of the duodenum in a post total gastrectomy patient without a cholecystoenteric fistula. The patient presented with epigastric pain. On abdominal computed tomography and percutaneous transhepatic choangiography imaging, the patient was found to have duodenal obstruction. At operation, the cause of obstruction was found to be a large gallstone in the third part of the duodenum, but there was no associated cholecystoenteric fistula. This report is the first to describe duodenal obstruction by a gallstone formed within the duodenum, in a patient post total gastrectomy with Roux-en-Y reconstruction, and highlights what can be a difficult diagnosis in such patients.
Department of Upper GI Surgery, Gloucestershire Royal Hospital, Gloucester, UK. brenton7476@aol.com
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D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D001658:Biliary Fistula; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004380:Duodenal Obstruction / Q000209:etiology*; D042882:Gallstones / Q000150:complications*; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D007412:Intestinal Fistula