Abstract
We experienced a case of gastric cancer of the anastomosed site occurred about 59 years after a gastrojejunostomy for cholelithiasis. An 81-year-old man was admitted to the hospital because of anemia, anorexia and dizziness. There was a previous history of undergoing gastrojejunostomy for cholelithiasis at the age of 22. A doublecontrast upper GI study showed a patent gastrojejunostomy with circumferential irregular stoma. Endoscopic exzamination with upper gastrointestinal endoscopy visualized a mass with ulceration around the anastomosed site. A biopsied specimen revealed well differentiated adenocarcinoma. Subtotal gastrectomy including the anastomosed site and partial excision of the jejunum with end-to-end anastomosis were carried out. The resected specimen was a type 3 advanced cancer, 30×30mm in size. Histologically the cancer lesion adjacent to adenoma and infiltrating across the stoma into the anastomosis of the jejunum. Lymph node metastasis was pathologically negative. There have been 22 cases of anastomatic gastric cancer following gastrojejunostomy without gastrectomy including this case so far. With regard to pathogenesis of gastric cancer after gastrojejunostomy, gastrojejunal anastomosis may develop atrophic gastritis and intestinal metaplasia as a result of chronic reflux of duodenal juice and these intestinal metaplasia may predispose to the development of gastric cancer. But unexplained facters also contribute to the development of cancer in these patients.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: The journal of the Japanese Practical Surgeon Society
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
