Successful Treatment of a Major Leakage of an Esophagojejunal Anastomosis after Open Total Gastrectomy: A Case Report

Abstract

Esophagojejunal leakage is one of the most serious complications in total gastrectomy surgery for proximal gastric cancer anastomotic leakage after this procedure occurs despite improvements in surgical techniques. Although many cases of dehiscence due to the medical condition of the patient can be managed non-operatively, major leakage requires second or more surgery. It can seriously lead to death or major complications.Case presentationThis report describes a 64-year-old man with a known case of proximal gastric adenocarcinoma, which underwent open total gastrectomy and esophagojejunal anastomosis. After the surgery, due to a major leak of anastomosis, which was diagnosed with oral gastrografin radiography pictures with patients fever and leukocytosis, the patient went to the operation room which at the second surgery esophagostomy and the jejunostomy feeding tube was inserted after six months esophagojejunotomy done and the patient tolerated the liquid and regular meals and was discharged.ConclusionMajor leakage of an esophagojejunal anastomosis is a severe complication of total gastrectomy. Although if the patient s condition tolerates the morbidity of this complication, re-anastomosis after six months of leakage is possible. Therefore, aggressive and urgent reoperation and effective drainage are useful once it is diagnosed.