Ischemic Jejunum Stricture: Lesson from Controlling Gastro Jejunostomy Bleeding by Coli Embolization after Pancreaticoduodenectomy: A Case Report and Literature Review

Wujun Wu, Lin Zhao, Yongtian Yu, Haitian Hu, Xiaogang Liu and Hua Sun

Department of Hepatobiliary Surgery, Shaanxi Provincial People’s Hospital, China
Department of Ophthalmology, The Second Affiliated Hospital of the Medical College of Xi’an Jiaotong University,
China

^*Correspondance to: Wujun Wu 

 PDF  Full Text DOI: 10.25107/2474-1647.2471

Abstract

The patient developed an episode of hemorrhage from the nasogastric tube at the first 24 h after surgery. Endoscopy failed to find the source of the bleeding. Emergency angiography showed an active bleeding site in jejunal side of gastrojejunostomy at 36 h after surgery. Coli embolization was performed to the branches of jejunal artery to save the life-threatening hemorrhage. After embolization, the patient experienced abdominal pain, fullness and weigh loss. The endoscopy and digestive tract iodine contrast showed severe stricture in the gastrojejunostomy, input segment as well as output segment. In the 50th day after embolization, the patient underwent surgical re-look procedure. In procedure, about 100 cm proximal jejunum was narrow severely without passing any food. Distance between gastrojejunal and Brown anastomosis was less than 5.0 cm. Another gastrojejunostomy was performed. The patient recovered smoothly and can eat ordinary diet in the 10th day after the second operation. The patient was in good condition and underwent no postoperative adjuvant therapy. Extensive liver metastasis was found at the 6th month after the second operation and she died 2 months later.

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Cite the article

Wu W, Zhao L, Yu Y, Hu H, Liu X, Sun H. Ischemic Jejunum Stricture: Lesson from Controlling Gastro Jejunostomy Bleeding by Coli Embolization after Pancreaticoduodenectomy: A Case Report and Literature Review. Clin Surg. 2019; 4: 2471.