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Ruchkin D.V.

Vishnevsky National Medical Research Center of Surgery

Okonskaya D.E.

Vishnevsky National Medical Research Center of Surgery

Kovalerova N.B.

Vishnevsky National Medical Research Center of Surgery

Kozlov V.A.

Vishnevsky National Medical Research Center of Surgery

Sokolova E.A.

Vishnevsky National Medical Research Center of Surgery

One-stage reconstructive jejunogastroplasty after previous multiple abdominal surgeries for left-sided diaphragm rupture complicated by gastric incarceration and necrosis

Authors:

Ruchkin D.V., Okonskaya D.E., Kovalerova N.B., Kozlov V.A., Sokolova E.A.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2023;(5): 92‑100

DOI: 10.17116/hirurgia202305192

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Table of contents

ONE-STAGE RECONSTRUCTIVE JEJUNOGASTROPLASTY AFTER PREVIOUS MULTIPLE ABDOMINAL SURGERIES FOR LEFT-SIDED DIAPHRAGM RUPTURE COMPLICATED BY GASTRIC INCARCERATION AND NECROSIS
ONE-STAGE RECONSTRUCTIVE JEJUNOGASTROPLASTY AFTER PREVIOUS MULTIPLE ABDOMINAL SURGERIES FOR LEFT-SIDED DIAPHRAGM RUPTURE COMPLICATED BY GASTRIC INCARCERATION AND NECROSIS

To cite this article:

Ruchkin DV, Okonskaya DE, Kovalerova NB, Kozlov VA, Sokolova EA. One-stage reconstructive jejunogastroplasty after previous multiple abdominal surgeries for left-sided diaphragm rupture complicated by gastric incarceration and necrosis. Pirogov Russian Journal of Surgery. 2023;(5):92‑100. (In Russ.)
https://doi.org/10.17116/hirurgia202305192

Подписка 2025-2 (Pirogov Russian Journal of Surgery)
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Acute gastric necrosis is a rare event requiring organ resection. Delayed reconstruction is advisable in patients with peritonitis and sepsis. The most common complication of gastrectomy with reconstruction is failure of esophagojejunostomy and duodenal stump. In case of severe esophagojejunostomy failure, appropriate surgical approach and timing of reconstructive stage should be analyzed. We report one-stage reconstructive surgery in a patient with multiple fistulas after previous gastrectomy. Surgery included reconstructive jejunogastroplasty with jejunal graft interposition. The patient underwent previous several unsuccessful reconstructive procedures complicated by failure of esophagojejunostomy and duodenal stump with external intestinal, duodenal and esophageal fistulas. Nutritional insufficiency, water and electrolyte disorders due to significant loss of proteins and intestinal juice through the drain tubes deteriorated clinical status. Surgical procedures finished reconstruction, provided closure of multiple fistulas and stomas and restored physiological duodenal passage.

Keywords:

acute gastric necrosis
gastrectomy
esophagojejunostomy leakage
duodenal stump leakage
jejunogastroplasty

Authors:

Ruchkin D.V.

Vishnevsky National Medical Research Center of Surgery

Okonskaya D.E.

Vishnevsky National Medical Research Center of Surgery

Kovalerova N.B.

Vishnevsky National Medical Research Center of Surgery

Kozlov V.A.

Vishnevsky National Medical Research Center of Surgery

Sokolova E.A.

Vishnevsky National Medical Research Center of Surgery

Received:

17.08.2022

Accepted:

10.09.2022

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