Document Detail


Identification and management of an errant antiperistaltic Roux limb after total gastrectomy.
MedLine Citation:
PMID:  15862271     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We recently evaluated two patients because of persistent, unexplained bilious vomiting following total gastrectomy with Roux-en-Y esophagojejunostomy. With the aid of intestinal manometry and reoperation, an antiperistaltic Roux limb was discovered in both cases. Isoperistaltic repositioning of the Roux limb led to resolution of both patients' symptoms. These case reports illustrate the devastating consequences of a poorly constructed Roux-en-Y esophagojejunostomy and demonstrate the utility of intestinal manometry in aiding the diagnosis of problems related to the Roux limb, particularly when surgical reexploration is not preferred or is inconclusive. By highlighting this avoidable technical error, we hope to prevent its future occurrence.
Authors:
John K DiBaise; Kishore Iyer; Jon S Thompson
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  9     ISSN:  1091-255X     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:    2005 May-Jun
Date Detail:
Created Date:  2005-05-02     Completed Date:  2005-11-07     Revised Date:  2006-10-20    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  726-32     Citation Subset:  IM    
Affiliation:
Intestinal Rehabilitation Program, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA. dibaise.john@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Anastomosis, Roux-en-Y / adverse effects*,  methods
Biliary Fistula / etiology*,  surgery*
Female
Follow-Up Studies
Gastrectomy / adverse effects*,  methods
Humans
Male
Manometry
Middle Aged
Polyps / diagnosis,  surgery
Postoperative Complications / diagnosis,  surgery
Reoperation
Risk Assessment
Stomach Neoplasms / diagnosis,  surgery
Treatment Outcome
Comments/Corrections
Comment In:
J Gastrointest Surg. 2006 Apr;10(4):622; author reply 623   [PMID:  16627232 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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