Wujun Wu1*, Lin Zhao2, Yongtian Yu1, Haitian Hu1, Xiaogang Liu1 and Hua Sun1
1Department of Hepatobiliary Surgery, Shaanxi Provincial People’s Hospital, China
2Department of Ophthalmology, The Second Affiliated Hospital of the Medical College of Xi’an Jiaotong University,
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.
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.