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胃腸吻合部 原位端 閉鎖症의 1例報告

Stomal Obstruction (Efferent Loop Syndrome) Following Vagotomy, Hemigastrectomy Antecolic Gastrojejunostomy. A Case Report.

대한외과학회지 1968년 10권 9호 p.641 ~ 647
鄭宗宇, 金周元, 趙平來,
소속 상세정보
鄭宗宇 (  ) - 釜山市 福音病院 一般外科
金周元 (  ) - 釜山市 福音病院 一般外科
趙平來 (  ) - 釜山市 福音病院 一般外科

Abstract


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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