Degastrectomy without vagotomy for perforated gastric stump ulcer and complete dehiscence of previous anastomosis in subtotal Roux-en-Y gastrectomy

Authors

  • Marcelo Fiusa Antunes Silva Colégio Brasileiro de Cirurgia Digestiva, Sorocaba, São Paulo
  • Jurandir Marcondes Ribas Filho Colégio Brasileiro de Cirurgia Digestiva, Curitiba, Paraná

DOI:

https://doi.org/10.37497/JMRReview.v1i1.8

Keywords:

RYGB, Degastrectomy, Gastric Ulcer, Dehiscence

Abstract

Background: Two of the main complications of Roux-en-Y gastric bypass (RYGB) are anastomoses dehiscence and marginal ulcerations, although the association between the two is considered rare. Aim: To report a case of degastrectomy without vagotomy performed in our Service due to a perforated gastric stump ulcer and complete dehiscence of the anastomosis after RYGB. Case Report: This is a patient treated at the Emergency Department of the General Surgery and Digestive System of Santa Casa de Sorocaba - SP. The patient had undergone an RYGB and, six months after the surgery, his gastric stump presented a perforating ulcer, and his anastomosis had a complete dehiscence. The resolution was based on performing a degastrectomy without vagotomy. After the procedure, the patient recovered well and was discharged seven days after the surgery. Ultrasonography and computed tomography were essential for the diagnosis of the complication. Conclusion: Degastrectomy is a highly efficient surgical option for perforating gastric stump ulceration with anastomotic dehiscence, and should be performed urgently for the best prognosis.

Author Biographies

Marcelo Fiusa Antunes Silva, Colégio Brasileiro de Cirurgia Digestiva, Sorocaba, São Paulo

Médico, Cirurgião Geral e do Trauma, Membro Efetivo do Colégio Brasileiro de Cirurgia Digestiva e Pós-graduando em Cirurgia do Aparelho Digestivo pelo Colégio Brasileiro de Cirurgia Digestiva, Sorocaba, São Paulo, Brasil.

Jurandir Marcondes Ribas Filho, Colégio Brasileiro de Cirurgia Digestiva, Curitiba, Paraná

Médico, Cirurgião Geral, Doutor em Clínica Cirúrgica pela Universidade Federal do Paraná, Membro Titular do Colégio Brasileiro de Cirurgia Digestiva, Curitiba, Paraná, Brasil.

References

Ilias EJ. What is the role of gastrectomy in the treatment of peptic ulcer? Rev Assoc Med Bras. fevereiro de 2011;57:9–9.

Cheng M, Li WH, Cheung MT. Early outcome after emergency gastrectomy for complicated peptic ulcer disease. Hong Kong Med J. agosto de 2012;18(4):291– 8.

Volpe P, Domene CE, Santana AV, Mira WG, Santo MA. Complications and late follow-up of scopinaro’s surgery with gastric preservation: 1570 patients operated in 20 years. Arq Bras Cir Dig. 35:e1646.

Rabben HL, Zhao CM, Hayakawa Y, Wang TC, Chen D. Vagotomy and Gastric Tumorigenesis. Curr Neuropharmacol. 2016;14(8):967–72.

Ramos MFKP, Martins B da C, Alves AM, Maluf-Filho F, Ribeiro-Júnior U, Zilberstein B, et al. Endoscopic stent for treatment of esophagojejunostomy fistula. ABCD, arq bras cir dig. setembro de 2015;28:216–7.

Pereira GA, Féres O, Andrade JI de, Ceneviva R. Síndrome da alça aferente com necrose simulando pseudocisto de pâncreas. Rev Col Bras Cir. abril de 1998;25:138–40.

Takano CK, Souza F de, Okawa M. Invaginaçäo jejunogástrica como causa de hemorragia digestiva. GED gastroenterol endosc dig. 1997;35–6.

Downloads

Published

2022-11-09

How to Cite

Antunes Silva, M. F., & Ribas Filho, J. M. (2022). Degastrectomy without vagotomy for perforated gastric stump ulcer and complete dehiscence of previous anastomosis in subtotal Roux-en-Y gastrectomy. Journal of Medical Residency Review, 1, e0229. https://doi.org/10.37497/JMRReview.v1i1.8

Issue

Vol. 1 (2022): Fluxo contínuo

Section

Artigos

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.