VS 01 - BN Chronic loop gastrojejunostomy volvulus masquerading as a Crohn’s stricture
Alex Yuen Hua Loh, Arkeliana Tase, Seiver Karim, Othman Al-Fagih, Periyathambi JambulingamAbstract
Background
A video presentation of a case of chronic loop gastrojejunostomy volvulus masquerading as a Crohn's stricture.
Method
61 year old female with a previous loop gastrojejunostomy and subsequent ileocaecal resection for Crohn's related pyloric stenosis and terminal ileal stricture. Acute worsening of post-prandial pain and vomiting 5 years later, re-investigation revealed a stenosed gastrojejunostomy thought to be Crohn's related.
Results
Intraoperative volvulus of the gastrojejunostomy was demonstrated related to traction forces resulting in the migration of the duodeno-jejunal flexure to the right of midline. The gastrojejunostomy was revised to a Roux-en-Y configuration with relief of mechanical obstruction.
Conclusion
An ileocaecal resection may create unexpected traction forces