A Case of Necrosis of the Gastric Remnant after Partial Gastrectomy

Hidetoshi Fujiwara, Yoshio Ishikawa, Yasuhiro Iwanaga, Masaaki Mitsutsuji, Hiromoto Shiki, Kazuyuki Wakita, Yoshihiro Kanbara, Yohko Sakoda, Hiroshi Kawasaki, Norio Kohno, Seishi Nakaya

Department of Surgery, Hyogo Medical Center for Adult

Ischemic necrosis of the gastric remnant is a rare and serious complication of distal gastrectomy. The authors report one case after distal gastrectomy without splenectomy, and a review of the literature. The patient was a 61-year-old woman who had recieved distal gastrectomy for early gastric cancer. On the 6 th postoperative day, the patient developed peritonitis due to perforation of the gastric remnant. At uregent laparotomy, a large necrotic area was found at the short gastric vessels of the gastric remnant. Total gastrectomy and abdominal drainage were performed. Seven months after surgery, the patient remains well. The overall mortality in a review of these cases was 70%. It is hoped that earlier diagnosis will lead to lower morbidity and mortality.

Key words
postoperative ischemia, gastric remnant

Reprint requests
Hidetoshi Fujiwara Department of Surgery, Hyogo Medical Center for Adult
13-70 Kitaohjicho, Akashi, 673 JAPAN

Accepted
November 9, 1994

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