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KMID : 0371319680100090641
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Journal of the Korean Surgical Society
1968 Volume.10 No. 9 p.641 ~ p.647
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Stomal Obstruction (Efferent Loop Syndrome) Following Vagotomy, Hemigastrectomy Antecolic Gastrojejunostomy. A Case Report.
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Abstract
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This 65 year-old Korean male was admitted to the Surgical Department of WALLACE MEMORIAL BAPTIST HOSPITAL on November 18, 1967 with complaining of epigastric distress, indigestion, acidbelching, regurgitation 10 years in duration. For the several months, he had been trouble with indigestion, hunger-pain, regurgitation, epigastric distress, and strenght.
Physical examination was negative except for epigastric pain.
Upper G-I series aspect of marked deformity of duodenal bulb with cicatrical changes which possible due to chronic peptic ulcer in the bulb.
On November 20, 1967 the patient was operated through upper median incision and had been vagotomy, hemigastrectomy, antecolic type gastrojejunostomy and then had checked early electrolyte and had corrected electrolyte imbalance, conservative treatment.
On November 30, 1967 (post op # 10 days) the patient had been abruptely onset of projectile vomiting (vomitus about 800cc) developed, and then had been nasogastric suction, intravenous hydration.
On December 6, 1967 (post op # 16 days) theupper G-I series study was performed, and had resulted marked disturbed passage of barium meal through the jejunal loop due to obstruction by perijunal adhesion.
On December 7, 1967 (post op # 17 days) the patient was made re-exploration and then was showed distal loop obstruction due to adhesion kinking of omentum, so that had been omentectomy and Allen-Donaldsons Double-jejunostomy at about 6 inch lenghs distally jejunum and about 1 inch length more distally for gastric decompression and feeding.
Convalecence was uneventful and the patient was discharged on December 30, 1967(post op # 24 days).
On March 20, 1968 (re-post op # 80 days) the patient was visited at clinic (O.P.D) and then had checked upper G-I series. the result had normal passage of barium meal from the junctioned canal of the stomach? was completed after 4 hours, and normal pattern of small bowel even which is very smooth passage.
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