Diseases of operated stomach

Diseases of operated stomach stomach diseases, developed in connection with a previous operational intervention. Most often develops after gastroenterostomy (see)produced about peptic ulcer of the duodenum and stomach.
At high acidity and long lead a loop of small bowel is developing a peptic ulcer anastomosis or jejunum, which gives severe clinical picture, poorly conservative treatment and prone to penetration (the perforation) in the surrounding organs with the formation of internal fistula (gastro colic). Treatment - resection of the stomach with the pestilence, and previously imposed by the anastomosis, vagotomy (see).


Fig. 3. Fistula between the stomach and the descending part of the duodenum. Fig. 4. Vicious circle (scheme).

A vicious circle as the disease operated stomach is that when a well-passable gatekeeper and gastrojejunostomy, superimposed on a long loop, the evacuation of the stomach occurs mainly via the gatekeeper. The content overflows the duodenum and causes the knee of the small intestine that extends and partly squeezes outlet intestine, making it difficult evacuation through it. In the food gets from crowded afferent loop partially or totally through the anastomosis back into the stomach (Fig. 4). The clinical course is characterized by progressive depletion, diarrhoeal disorders, nausea, vomiting. In the diagnosis helps the x-ray examination, indicating the passage of barium through the anastomosis in the stomach. Treatment - resection of the stomach and anastomosis, the imposition of additional entero-enteroanastomosis between the leading and lateral loops jejunum.
Anastomotic - emerged postoperative acute inflammation of the gastro-intestinal anastomosis, accompanied by its contraction and a violation of the evacuation. Clinical manifestations associated with the accumulation in the stomach or his cult liquid contents and gases, which leads to nausea and vomiting eaten food. Sometimes in the epigastric region is determined by palpation infiltration (see). Radiographically set the delay evacuation of contrast material. Treatment - anti-inflammatory therapy (antibiotics, intravenous calcium chloride, radiotherapy in anti-inflammatory doses), long suction congestive content thin probe. Repeated surgical intervention (gastrojejunostomy - only when unsuccessful application conservative measures. Long-existing anastomotic leads to deformation and narrowing of anastomosis, which requires a second surgery - gastric resection with anastomosis.
Post-resection syndrome means a group of diseases that occur as late complication after resection of the stomach. Includes a number of disorders: impaired patency of food, violations of blood (Australia anemia), and other