Revision Surgery for Jejunal Pouch Dysfunction after Subtotal Gastrectomy: A Case Report

Abstract

We report a subtotal gastrectomy complication arising from severe jejunal pouch dysfunction that was treated with a revision surgery. A 79-year-old woman had undergone a subtotal gastrectomy about 45 years earlier and had reported chronic symptoms of postprandial cramping and vomiting since the procedure. She was admitted because of persistent painful upper quadrant cramping and vomiting. Radiological findings revealed a severe dilation of the jejunal pouch suggesting pouch dysfunction. The patient preferred a simple solution, and a revision surgery was suggested. During a laparotomy, the previous reconstruction with jejunal pouch and Roux-en-Y anastomosis was revised through a pouch resection and a new Roux-en-Y anastomosis. On the third post-operative day, the patient resumed dietary intake and did not develop reflux or stasis. The revision surgery was effective for the restoration of gastrointestinal transit, and the patient was satisfied with the results.