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One-step surgery for acute ischemia of the jejunal loop after pancreatoduodenectomy: report of a case

BACKGROUND: Pancreatoduodenectomy (PD) is an extensive surgery, and its complications are grave. Acute ischemia of the jejunal loop due to thrombosis of the superior mesenteric vein (SMV) and its branches is one of the most dangerous complications that, although rare, if left untreated leads to abdo...

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Autores principales: Kayashima, Hiroto, Maeda, Takashi, Harada, Noboru, Masuda, Takanobu, Ohmine, Takahiro, Yamaguchi, Shohei, Matsuyama, Ayumi, Hamatake, Motoharu, Tsutsui, Shinichi, Matsuda, Hiroyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4791446/
https://www.ncbi.nlm.nih.gov/pubmed/26976614
http://dx.doi.org/10.1186/s40792-016-0153-6
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author Kayashima, Hiroto
Maeda, Takashi
Harada, Noboru
Masuda, Takanobu
Ohmine, Takahiro
Yamaguchi, Shohei
Matsuyama, Ayumi
Hamatake, Motoharu
Tsutsui, Shinichi
Matsuda, Hiroyuki
author_facet Kayashima, Hiroto
Maeda, Takashi
Harada, Noboru
Masuda, Takanobu
Ohmine, Takahiro
Yamaguchi, Shohei
Matsuyama, Ayumi
Hamatake, Motoharu
Tsutsui, Shinichi
Matsuda, Hiroyuki
author_sort Kayashima, Hiroto
collection PubMed
description BACKGROUND: Pancreatoduodenectomy (PD) is an extensive surgery, and its complications are grave. Acute ischemia of the jejunal loop due to thrombosis of the superior mesenteric vein (SMV) and its branches is one of the most dangerous complications that, although rare, if left untreated leads to abdominal sepsis and death of a patient. CASE PRESENTATION: A 77-year-old man underwent PD for pancreatic cancer. On postoperative day 2, the patient developed a severe anemia with hypotension. The computed tomography showed acute ischemia of the jejunal loop due to thrombosis. The emergent surgery was performed. The removal of the ischemic intestine and re-anastomoses of the biliary and pancreatic ducts could be performed all at once because necrosis and inflammation were still very mild in early stage. CONCLUSION: If suspicion for thrombosis of the SMV and its branches is raised, re-laparotomy should be considered. Early re-operation can lead to removal of the ischemic intestine and re-anastomoses in one-step surgery.
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spelling pubmed-47914462016-04-09 One-step surgery for acute ischemia of the jejunal loop after pancreatoduodenectomy: report of a case Kayashima, Hiroto Maeda, Takashi Harada, Noboru Masuda, Takanobu Ohmine, Takahiro Yamaguchi, Shohei Matsuyama, Ayumi Hamatake, Motoharu Tsutsui, Shinichi Matsuda, Hiroyuki Surg Case Rep Case Report BACKGROUND: Pancreatoduodenectomy (PD) is an extensive surgery, and its complications are grave. Acute ischemia of the jejunal loop due to thrombosis of the superior mesenteric vein (SMV) and its branches is one of the most dangerous complications that, although rare, if left untreated leads to abdominal sepsis and death of a patient. CASE PRESENTATION: A 77-year-old man underwent PD for pancreatic cancer. On postoperative day 2, the patient developed a severe anemia with hypotension. The computed tomography showed acute ischemia of the jejunal loop due to thrombosis. The emergent surgery was performed. The removal of the ischemic intestine and re-anastomoses of the biliary and pancreatic ducts could be performed all at once because necrosis and inflammation were still very mild in early stage. CONCLUSION: If suspicion for thrombosis of the SMV and its branches is raised, re-laparotomy should be considered. Early re-operation can lead to removal of the ischemic intestine and re-anastomoses in one-step surgery. Springer Berlin Heidelberg 2016-03-14 /pmc/articles/PMC4791446/ /pubmed/26976614 http://dx.doi.org/10.1186/s40792-016-0153-6 Text en © Kayashima et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Report
Kayashima, Hiroto
Maeda, Takashi
Harada, Noboru
Masuda, Takanobu
Ohmine, Takahiro
Yamaguchi, Shohei
Matsuyama, Ayumi
Hamatake, Motoharu
Tsutsui, Shinichi
Matsuda, Hiroyuki
One-step surgery for acute ischemia of the jejunal loop after pancreatoduodenectomy: report of a case
title One-step surgery for acute ischemia of the jejunal loop after pancreatoduodenectomy: report of a case
title_full One-step surgery for acute ischemia of the jejunal loop after pancreatoduodenectomy: report of a case
title_fullStr One-step surgery for acute ischemia of the jejunal loop after pancreatoduodenectomy: report of a case
title_full_unstemmed One-step surgery for acute ischemia of the jejunal loop after pancreatoduodenectomy: report of a case
title_short One-step surgery for acute ischemia of the jejunal loop after pancreatoduodenectomy: report of a case
title_sort one-step surgery for acute ischemia of the jejunal loop after pancreatoduodenectomy: report of a case
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4791446/
https://www.ncbi.nlm.nih.gov/pubmed/26976614
http://dx.doi.org/10.1186/s40792-016-0153-6
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