title: Management of post-gastrectomy anastomosis site obstruction with a self-expandable metallic stent.
abstract: Post-gastrectomy anastomosis site obstruction is a relatively rare complication after a subtotal gastrectomy. We present a case of a 75-year-old man who underwent a truncal vagotomy, omental patch, gastrojejunostomy, and Braun anastomosis for duodenal ulcer perforation and a gastric outlet obstruction. Following the 10(th) postoperative day, the patient complained of abdominal discomfort and vomiting. We diagnosed post-gastrectomy anastomosis site obstruction by an upper gastrointestinal series and an upper endoscopic examination. We inserted a self-expandable metallic stent (SEMS) at the anastomosis site. The stent was fully expanded after deployment. On the day following the stent insertion, the patient began to eat, and his abdominal discomfort was resolved. This paper describes the successful management of post-gastrectomy anastomosis site obstruction with temporary placement of a SEMS.
authors.affiliation: Ra Ri Cha, Sang Soo Lee, Hyunjin Kim, Hong Jun Kim, Tae-Hyo Kim, Woon Tae Jung, Ok Jae Lee, Chang Yoon Ha, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Gyeongnam 660-702, South Korea.
authors.forename: Ra Ri
authors.initials: RR
authors.lastname: Cha
authors.affiliation: Ra Ri Cha, Sang Soo Lee, Hyunjin Kim, Hong Jun Kim, Tae-Hyo Kim, Woon Tae Jung, Ok Jae Lee, Chang Yoon Ha, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Gyeongnam 660-702, South Korea.
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Ra Ri Cha, Sang Soo Lee, Hyunjin Kim, Hong Jun Kim, Tae-Hyo Kim, Woon Tae Jung, Ok Jae Lee, Chang Yoon Ha, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Gyeongnam 660-702, South Korea.
authors.forename: Hyunjin
authors.initials: H
authors.lastname: Kim
authors.affiliation: Ra Ri Cha, Sang Soo Lee, Hyunjin Kim, Hong Jun Kim, Tae-Hyo Kim, Woon Tae Jung, Ok Jae Lee, Chang Yoon Ha, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Gyeongnam 660-702, South Korea.
authors.forename: Hong Jun
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Ra Ri Cha, Sang Soo Lee, Hyunjin Kim, Hong Jun Kim, Tae-Hyo Kim, Woon Tae Jung, Ok Jae Lee, Chang Yoon Ha, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Gyeongnam 660-702, South Korea.
authors.forename: Tae-Hyo
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Ra Ri Cha, Sang Soo Lee, Hyunjin Kim, Hong Jun Kim, Tae-Hyo Kim, Woon Tae Jung, Ok Jae Lee, Chang Yoon Ha, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Gyeongnam 660-702, South Korea.
authors.forename: Woon Tae
authors.initials: WT
authors.lastname: Jung
authors.affiliation: Ra Ri Cha, Sang Soo Lee, Hyunjin Kim, Hong Jun Kim, Tae-Hyo Kim, Woon Tae Jung, Ok Jae Lee, Chang Yoon Ha, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Gyeongnam 660-702, South Korea.
authors.forename: Ok Jae
authors.initials: OJ
authors.lastname: Lee
authors.affiliation: Ra Ri Cha, Sang Soo Lee, Hyunjin Kim, Hong Jun Kim, Tae-Hyo Kim, Woon Tae Jung, Ok Jae Lee, Chang Yoon Ha, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Gyeongnam 660-702, South Korea.
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Bae
authors.affiliation: Ra Ri Cha, Sang Soo Lee, Hyunjin Kim, Hong Jun Kim, Tae-Hyo Kim, Woon Tae Jung, Ok Jae Lee, Chang Yoon Ha, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Gyeongnam 660-702, South Korea.
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Jeong
authors.affiliation: Ra Ri Cha, Sang Soo Lee, Hyunjin Kim, Hong Jun Kim, Tae-Hyo Kim, Woon Tae Jung, Ok Jae Lee, Chang Yoon Ha, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Gyeongnam 660-702, South Korea.
authors.forename: Chang Yoon
authors.initials: CY
authors.lastname: Ha
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D003251:Constriction, Pathologic; D020878:Device Removal; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation*; D005743:Gastrectomy / Q000009:adverse effects*; D015390:Gastric Bypass / Q000009:adverse effects*; D017219:Gastric Outlet Obstruction / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008670:Metals; D011474:Prosthesis Design; D012074:Remission Induction; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals
keywords: Efferent loop syndrome; Postgastrectomy syndrome; Self-expandable metallic stent