A Gastric Volvulus After the Whipple Procedure in a Pancreatic Cancer: A Case Report

Document Type : Case Reports and Brief Reports

Authors

1 Department of Surgery, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 Department of Surgery, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.

10.22118/jjo.2016.167575

Abstract

Vomiting and delayed gastric emptying are common complications after the Whipple surgery. In
our patient, this complaint was related to gastric volvulus. Gastric volvulus is a life-threatening
condition characterized by an abnormal rotation of the stomach around an axis. The first line of
treatment for this disorder is surgical. We present a 67 years old male patient with a history of
pancreatic cancer status after the pylorus-preserving Whipple procedure. The patient presented
with nausea and vomiting after surgery. Computed tomography revealed a normal anatomic
structure without any abscess or hematoma. In the barium swallow study, partial stenosis in the
anastomosis site and delayed stomach emptying was diagnosed. On the 23rd day after the first
surgery, we performed a detorsion of the stomach with a gastric volvulus diagnosis. Gastric
volvulus could be a complication of pancreatoduodenectomy, and performing gastropexy
during the Whipple surgery may prevent this complication. For evaluating treatments, best
diagnostic studies, and risk factors, more studies are needed.

Highlights

Amin Bahreini (PubMed)(Google Scholar)

Khalil Kazemnia (PubMed)(Google Scholar)

Keywords

References

[1] Konstantinos B, Konstantinos AB, Konstantinos T, Anestis
H. Management of afferent loop obstruction: Reoperation
or endoscopic and percutaneous interventions?
World Journal of Gastrointestinal Surgery. 2015; 7(9):190-5.
[DOI:10.4240/wjgs.v7.i9.190] [PMID] [PMCID]
[2] Kageyama Y, Yamaguchi R, Watanabe S, Aizu K, Kobayashi
S, Sato F, et al. Pancreaticoduodenectomy with malrotation
following reoperation due to torsion of efferent
loop: A case report. Surgical Case Reports. 2020; 6(1):1-6.
[DOI:10.1186/s40792-020-00991-x] [PMID] [PMCID]
[3] Snyder Jr WH, Chaffin L. Embryology and pathology of the
intestinal tract: Presentation of 40 cases of malrotation. Annals
of Surgery. 1954; 140(3):368-79. [DOI:10.1097/00000658-
195409000-00013] [PMID] [PMCID]
[4] Traverso LW, Longmire Jr WP. Preservation of the pylorus
in pancreaticoduodenectomy. Surgery, Gynecology
& Obstetrics. 1978; 146(6):959-62. [Link]
[5] Gourgiotis S, Vougas V, Germanos S, Baratsis S.
Acute gastric volvulus: Diagnosis and management
over 10 years. Digestive Surgery. 2006; 23(3):169-72.
[DOI:10.1159/000094456] [PMID]
[6] Wenming Wu, Xiafei H, Lilan Fu, Shanglong L, Lei Y, Li
Z, et al. The effect of pylorus removal on delayed gastric
emptying after pancreaticoduodenectomy: A metaanalysis
of 2,599 patients. Plos One. 2014; 9(10):1-10. [DOI:10.1371/
journal.pone.0108380] [PMID] [PMCID]
[7] Kawai M, Tani M, Hirono S, Miyazawa M, Shimizu A, et
al. Pylorus ring resection reduces delayed gastric emptying
in patients undergoing pancreatoduodenectomy: A
prospective, randomized, controlled trial of pylorus-resecting
versus pylorus-preserving pancreatoduodenectomy.
Annals of Surgery. 2011; 253(3):495-501. [DOI:10.1097/
SLA.0b013e31820d98f1] [PMID]
[8] Wente MN, Bassi C, Dervenis C, Fingerhut A, Gouma DJ,
Jakob RI, et al. Delayed gastric emptying (DGE) after pancreatic
surgery: A suggested definition by the International
Study Group of Pancreatic Surgery (ISGPS). Surgery. 2007;
142(5):761-8. [DOI:10.1016/j.surg.2007.05.005] [PMID]
[9] Emekli E, Gündoğdu E. Computed tomography evaluation
of early post-operative complications of the Whipple
procedure. Polish Journal of Radiology. 2020; 85(1):104-9.
[DOI:10.5114/pjr.2020.93399] [PMID] [PMCID]
[10] Raman SP, Horton KM, Cameron JL, Fishman EK. CT
after pancreaticoduodenectomy: Spectrum of normal findings
and complications. American Journal of Roentgenology.
2013; 201(1):2-13. [DOI:10.2214/AJR.12.9647] [PMID]
Jundishapur Journal of Oncology
Volume 2, Issue 2 - Serial Number 4
December 2016
Pages 63-65

Files

History

  • Receive Date: 17 May 2016
  • Revise Date: 22 May 2016
  • Accept Date: 18 June 2016

Share

How to cite

Statistics