Spontaneous Jejunum Rupture triggered Overextension due to Excessive Oral Intake Excessive Post-total-gastrectomy Intake Triggers Spontaneous Jejunum Rupture: A Case Report

• Published in: The Japanese Journal of Gastroenterological Surgery Vol. 44; no. 3; pp. 246 - 251
• Main Authors: Kumamoto, Yusuke, Kanai, Toshio, Nakagawa, Motohito, Nagase, Takeshi, Imai, Shun, Wada, Osamu, Hoshino, Go, Honda, Tomo, Asagoe, Tatsuo
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 2011
• Subjects: complication; spontaneous jejunum rupture; total gastrectomy
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.44.246

We report a case of spontaneous jejunum rupture following total gastrectomy. An 83-year-old woman with dementia undergoing total gastrectomy for gastric cancer and esophagojejunostomy through the retrocolic root was discharged on postoperative day 19. Two months later, she was seen in an emergency for acute abdominal pain. Physical examination showed muscular abdominal defense. Computed tomography showed abdominal free air necessitating emergency surgery for panperitonitis due to a perforated digestive tract. Surgical findings showed the left upper abdominal cavity to be filled with a food mass and 5cm of the anal side of the jejunum from the esophagojejunostomy torn in a half circle. Neither ulceration nor inflammation was seen, and a diagnosis of spontaneous jejunum rupture enabled the lesion to be sutured in two layers followed by abdominal lavage and draining. No stenosis was seen at the distal jejunum, so we concluded that excessive oral intake expanding the jejunum had triggered a spontaneous jejunum rupture.