문합부 후방 탈장으로 발생한 위 허혈과 소장 경색 1예
Ischemic Necrosis Caused by Retroanastomotic Hernia after Subtotal Gastrectomy
이상훈, 박성철, 이성준, 강창돈, 남승주, 이승엽, 홍성권, 이승구,
소속 상세정보
이상훈 ( Lee Sang-Hoon )
강원대학교 의학전문대학원 내과학교실
박성철 ( Park Sung-Chul )
강원대학교 의학전문대학원 내과학교실
이성준 ( Lee Sung-Joon )
강원대학교 의학전문대학원 내과학교실
강창돈 ( Kang Chang-Don )
강원대학교 의학전문대학원 내과학교실
남승주 ( Nam Seung-Joo )
강원대학교 의학전문대학원 내과학교실
이승엽 ( Lee Seung-Yup )
강원대학교 의학전문대학원 내과학교실
홍성권 ( Hong Seong-Kweon )
강원대학교 의학전문대학원 외과학교실
이승구 ( Lee Seung-Koo )
강원대학교 의학전문대학원 해부병리학교실
Abstract
After gastrojejunostomy, a small space can occur between the jejunum at the anastomosis site, the transverse mesocolon, and retroperitoneum, which may cause an intestinal hernia. This report presents a rare case of intestinal ischemic necrosis caused by retroanastomotic hernia after subtotal gastrectomy. A 56-year-old male was admitted to Kangwon National University Hospital with melena, abdominal pain, and nausea. His only relevant medical history was gastrectomy due to stomach cancer. Endoscopic findings revealed subtotal gastrectomy with Billroth-II reconstruction and a bluish edematous mucosal change with necrotic tissue in afferent and efferent loops including the anastomosis site. Abdominopelvic CT showed strangulation of proximal small bowel loops due to mesenteric torsion and thickening of the wall of the gastric remnant. Emergency laparotomy was performed. Surgical findings revealed the internal hernia through the defect behind the anastomosis site with strangulation of the jejunum between 20 cm below the Treitz ligament and the proximal ileum. Roux-en-Y anastomosis was performed, and he was discharged without complication. Retroanastomotic hernia, also called Petersen’s space hernia, is a rare complication after gastric surgery, cannot be easily recognized, and leads to strangulation
키워드
Hernia; Ischemia; Necrosis; Gastrectomy
원문 및 링크아웃 정보
등재저널 정보