Abstract
IntroductionGastric adenocarcinoma is a known complication of partial gastrectomy. Jaundice from gastric adenocarcinoma usually occurs in the setting of hepatic nodal or parenchymal metastasis. This case demonstrates an unusual level of biliary obstruction from gastric adenocarcinoma.Case presentationAn 84-year-old Caucasian man was diagnosed as having a new gastric adenocarcinoma at the level of the gastroenteric anastomosis of a prior Billroth II gastrectomy after presenting with painless jaundice. He had a non-dilated biliary tree on radiographic imaging despite evidence of large bile duct obstruction on liver biopsy. The obstruction was managed with endoscopic wire-guided stenting of the malignant tumor.ConclusionsThe unusual finding of a non-dilated biliary tree in the face of obstructive jaundice is likely to have resulted from the unusual post-surgical anatomy and hence distal level of obstruction. Endoscopic duodenal stenting is a novel method of managing obstructive jaundice in gastric adenocarcinoma.
Highlights
Gastric adenocarcinoma is a known complication of partial gastrectomy
The unusual finding of a non-dilated biliary tree in the face of obstructive jaundice is likely to have resulted from the unusual post-surgical anatomy and distal level of obstruction
Endoscopic duodenal stenting is a novel method of managing obstructive jaundice in gastric adenocarcinoma
Summary
The unusual finding of a non-dilated biliary tree in the face of obstructive jaundice is likely to have resulted from the unusual post-surgical anatomy and distal level of obstruction.
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