2019 Volume 39 Issue 3 Pages 567-570
An 82-year-old man who had undergone laparoscopic total gastrectomy and antecolic Roux-en-Y reconstruction for early-stage gastric cancer 3 years previously visited our hospital with abdominal pain and vomiting. Abdominal computed tomography revealed dilatation, thinning, pneumatosis intestinalis, and closed loop formation in the ascending jejunal limb. We diagnosed strangulation with a small bowel obstruction and performed emergency surgery. During the surgery, we found that the ascending jejunal limb was obstructed by a band of tissue between the appendix epiploica of the transverse colon and jejunal mesentery. We transected the band and resected the ascending jejunal limb from the anal side of the esophagojejunostomy to the anal side of the Roux-en-Y limb and then reconstructed it as before. The patient’s hospital stay was prolonged because of aspiration pneumonia and malnutrition, but we transferred him to another hospital to continue dysphagia rehabilitation 41 days postoperatively. We have not seen any reports of strangulations with small bowel obstruction of the ascending jejunal limb after gastrectomy in the previous 10 years；therefore, to the best of our knowledge, this is the first case report of this condition. We have discussed and reported on this case with some reviews of the pertinent literature.
