A Case of Major Anastomotic Failure after Distal Gastrectomy for Gastric Cancer Successfully Treated witha Transnasal Drainage Tube

Abstract

A 72-year-old male patient who had undergone distal gastrectomy for gastric cancer after endoscopic submucosal dissection returned to our hospital with the complaints of fever and vomiting. Contrast-enhanced CT revealed intraperitoneal abdominal free air and an abscess. The diagnosis of major anastomotic failure was made, although a postoperative radiographic contrast study revealed no evidence of leakage. We performed transnasal drainage. Due to intermittent aspiration via the drainage tube, the abscess decreased in size and the patient resumed oral intake. He was discharged from the hospital after 47 days of admission. In many cases of major anastomotic failure, invasive surgical treatment is selected. However, we have reported a case of anastomotic failure that was successfully treated by a transnasal drainage tube without recourse to any invasive surgical procedure.