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Postoperative Duodenojejunal Obstruction Following Gastric Resection

AMA Arch Surg. 1960;80(3):464-467. doi:10.1001/archsurg.1960.01290200108019.
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Obstruction of the duodenum or afferent jejunal loop following gastric resection and gastrojejunostomy presents a distinctive clinical picture. It is important to recognize this complication and to be aware of some of its common causes and methods of prevention.

In 1942, Lynn, Hay, and Wangensteen reported autopsy findings on three patients with unexplained dilatation of the duodenojejunal loop.11 A syndrome consisting of distention of the duodenojejunal loop, hyperthermia, and vascular collapse resulting in death was described. The authors attributed the syndrome to sharp angulation or kinking of the loop at the afferent inlet. A similar clinical picture was produced in dogs by creating an obstructed duodenal loop.

Five patients with afferent loop distention resulting from postoperative mechanical obstruction at the anastomosis or the opening in the mesocolon in retrocolic anastomoses have been described by Hartmann.7 These patients developed abdominal pain, fever, and tachycardia. Peripheral vascular collapse and death


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