A Case of Jejunal Ulcer at the Site of Side-to-Side Anastomosis between the Jejunum and Transverse Colon

Masahiro Terabe, Eiji Minato, Hiroshi Koike, Masaki Fujioka and Keiji Iriyama

Department of Surgery, City Hospital of Kuwana

A 41-year-old man admitted for persistent anemia had a history of 2 laparotomies, the first for intussusception at age 3 and the second for intestinal obstruction at age 9. In the second laparotomy, he underwent side-to-side anastomosis between the small intestine and transverse colon. At age 37, he was diagnosed with an ulcer at the anastomotic site. Persistent anemia necessitated surgery, during which we found a blind intestinal loop formed by the antiperistaltic side-to-side anastomosis between the jejunum and transverse colon. The anastomosis was 150 cm distal to the ligament of Treitz. We partially resected the jejunum and transverse colon. We found an annular ulcer of the jejunum adjacent to the proximal edge of the anastomosis. The histological diagnosis was a nonspecific ulcer. Ulcer associated with a blind loop syndrome develops at an imtestinal site stimulated by stagnant intestinal contents or struck by intestinal flow. We consider our case to be rare.

Key words
blind loop syndrome, ulcer

Reprint requests
Masahiro Terabe Department of Surgery, City Hospital of Kuwana 435 Kitabessho, Kuwana, Mie, 511-0819 JAPAN

Accepted
December 18, 2002

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