Invagination of the Adductor Loop of the Small Intestine into the Lumen of the Gastric Stump after Pancreatoduodenal Resection

Abstract

Aim. To present a rare clinical observation of invagination of the adductor loop of the small intestine into the lumen of the gastric stump after pancreatoduodenal resection. Results. A 69-year-old patient complained of paroxysmal abdominal pain, nausea, vomiting without relief. The patient also reported an episode of black stools 7 years after pancreatoduodenal resection for pancreatic head cancer and 3 years after reconstructive surgery by performing choledochoenteroanastomosis. The invagination of the adductor loop of the small intestine into the lumen of the gastric stump was identified. The mobilization and resection of a fragment of the jejunum with an invagination zone was performed followed by suturing of the distal end of the intestine. Conclusions. Small bowel invagination after abdominal surgery occurs in 1–5% of cases. This case of invagination of the blind end of the adductor loop into the gastric stump through gastroenteroanastomosis caused an acute adductor loop syndrome in the patient. No similar cases have been reported in Russian and foreign publications.

Keywords

• invagination
• adductor loop
• gastric stump
• pancreatoduodenal resection
• esophagogastroduodenoscopy