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Iatrogenic problems following gastric surgery

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Abstract

It is difficult to truly define iatrogenic complications in the postsurgical state in that the surgery is a condition originated by physician intervention and thus any problems that occur may be technically considered as physician created. In this article we attempt to demonstrate problems that occur both due to technical errors and the choice of operative procedure. In addition, unusual postsurgical anatomy is illustrated with the hope of avoiding further iatrogenic problems from lack of recognition.

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References

  1. Macleod JB: the surgery of peptic ulcer.Scott Med J 16:141, 1971

    Google Scholar 

  2. Tanner NC: The surgical treatment of peptic ulcer.Br J Surg 52:5, 1964

    Google Scholar 

  3. Hoerr SO: A review and evaluation of operative procedures used for chronic duodenal ulcer.Surg Clin North Am 56:1289, 1976

    Google Scholar 

  4. Hardy JD: Problems associated with gastric surgery—A review of 604 consecutive patients with annotation.Am J Surg 108:699, 1964

    Google Scholar 

  5. Dodsworth JM, Fischer JE: Surgical therapy of chronic peptic ulcer—Preoperative assessment, choice of operations and consequences.Surg Clin North Am 54:529, 1974

    Google Scholar 

  6. Herrington JL, Sawyers JL, Scott HW: A 25-year experience with vagotomy—antrectomy.Arch Surg 106:469, 1973

    Google Scholar 

  7. Johnston D: A therapeutic index (scoring system) for the evaluation of operations for peptic ulcer.Gastroenterblogy 70:433, 1976

    Google Scholar 

  8. Johnston D: Operative mortality and postoperative morbidity of highly selective vagotomy.Br J Surg 62:160, 1975

    Google Scholar 

  9. Dozois R, Kelly K: Gastric secretion and motility in duodenal ulcer: Effect of current vagotomies.Surg Clin North Am 56:1267, 1976

    Google Scholar 

  10. Johnston D, Humphrey CS, Walker BE, Pulvertaft CN, Goligher JC: Vagotomy without diarrhea.Br Med J 3:788, 1972

    Google Scholar 

  11. Baron JH, Spencer J: Facts and heresies about vagotomy.Surg Clin North Am 56:1297, 1976

    Google Scholar 

  12. Johnston D, Goligher JC: Selective, highly selective, or truncal vagotomy in 1976—A clinical appraisal.Surg Clin North Am 56:1313, 1976

    Google Scholar 

  13. DeMeester TR, Johnson LF, Kent AH: Evaluation of current operations for prevention of gastroesophageal reflux.Ann Surg 180:511, 1974

    Google Scholar 

  14. Maingot R:Abdominal Operations. 6th Ed. Vol. 1, Appleton-Century-Crofts, New York, 1974

    Google Scholar 

  15. Burhenne HJ: Roentgen anatomy and terminology of gastric surgery.Am J Roentgenol Radium Ther Nucl Med 91:731, 1964

    Google Scholar 

  16. Burrell M, Curtis AM: Sequelae of stomach surgery.CRC Crit Rev Diag Imag 10:17–97, 1977

    Google Scholar 

  17. Zatzkin HR, Riera A: Upper gastrointestinal examination after gastric surgery.Radiology 55:193, 1950

    Google Scholar 

  18. Templeton FE: The stomach after operation. Radiologic considerations of types of operation, peptic ulcer and neoplasm.Cleve Clin Q 11:27, 1944

    Google Scholar 

  19. Gold RD, Seaman WB: The primary double-contrast examination of the postoperative stomach.Radiology 124:297, 1977

    Google Scholar 

  20. Kraft RO, Fry WJ, DeWeese MS: Post-vagotomy gastric atony.Arch Surg 88:865, 1964

    Google Scholar 

  21. Rimer DG: Gastric retention without mechanical obstruction: A review.Arch Intern Med 117:287, 1966

    Google Scholar 

  22. Bryant LR, Wiot JF, Kloecker RJ: A study of the factors affecting the incidence and duration of postoperative pneumoperitoneum.Surg Gynecol Obstet 117:145, 1963

    Google Scholar 

  23. Heslin DJ, Malt RA: Progressive postoperative pneumoperitoneum: Air entering through drain sites.Am J Roentgenol Radium Ther Nucl Med 92:1166, 1964

    Google Scholar 

  24. Nissen R, Rossetti M: Surgery of hiatal and other diaphragmatic hernias.J Int Col Surg 43:663, 1965

    Google Scholar 

  25. Fergin DS, James AE Jr, Stitik FP, Donner MW, Skinner DB: The radiological appearance of hiatal hernia repairs.Radiology 110:71, 1974

    Google Scholar 

  26. Skucas J, Mangla JC, Adams JT, Cutcliff W: An evaluation of the Nissen fundoplication.Radiology 118:539, 1976

    Google Scholar 

  27. Fisher MS: The Hofmeister defect—A normal change in the postoperative stomach.Am J Roentgenol Radium Ther Nucl Med 84:1082, 1960

    Google Scholar 

  28. Burhenne HJ: The postoperative stomach. In:Alimentary Tract Roentgenology. AR Margolis, HJ Burhenne, eds., 2d Edition. Vol. 1, Chap. 29, p. 740, 1973

  29. Kirklin BR: Roentgenologic determination of normal and abnormal results following operation on the stomach and duodenum.Am J Roentgenol Radium Ther Nucl Med 33:468, 1935

    Google Scholar 

  30. Eklöf O, Ohlsson S: Postoperative plication deformity with foreign-body granuloma simulating tumor of the stomach. Report of 3 cases.Acta Chir Scand 123:125, 1962

    Google Scholar 

  31. Nunez D Jr, Bjarnason T, Schwartz SS: Barium findings in retrograde intussusception.Am J Roentgenol Radium Ther Nucl Med 125:717, 1975

    Google Scholar 

  32. Shulman H: Passing the Cantor tube in a patient with gastroenterostomy: An unusual complication.Am J Roentgenol Radium Ther Nucl Med 110:332, 1970

    Google Scholar 

  33. Engel S: Gastrostomy.Surg Clin North Am 49:1289, 1969

    Google Scholar 

  34. Connar RG, Sealy WC: Gastrostomy and its complications.Ann Surg 143:245, 1956

    Google Scholar 

  35. Goodman LR, Wittenberg J, Messer R: Duodenal obstruction —An unusual complication of a gastrostomy feeding catheter.Br J Radiol 44:883, 1971

    Google Scholar 

  36. Haws EB, Sieber WK,Kiesewetter WB: Complications of tube gastrostomy in infants and children.Ann Surg 164:284, 1966

    Google Scholar 

  37. Manfredi D, Campioni N, LaFerla G, Filipetti, M: Tube prosthesis in the palliative treatment of cancer of the esophagus and cardia.Ann Ital Chir 48:215, 1976

    Google Scholar 

  38. Anscombe AR, Pearson K, Taylor TV: A simple method for the introduction of an oesophageal tube in advanced carcinoma of the oesophagus.Br J Surg 63:947, 1976

    Google Scholar 

  39. Atkinson M, Ferguson R: Fiberoptic endoscopic palliative intubation of inoperable oesophagogastric neoplasm.Br Med J 1:266, 1977

    Google Scholar 

  40. Goldstein R, Butterfield W: Modified Nissen fundoplication and the “Gas-bloat” syndrome as measured by the inability to vomit—an experimental study.Am J Surg 126:89, 1973

    Google Scholar 

  41. Woodward ER: Comparison of crural repair and Nissen fundoplication.Ann Surg 173:782, 1971

    Google Scholar 

  42. Polk HC Jr: Hiatal hernia and esophagitis: A survey of indications for operation and technique and results of fundoplication.Ann Surg 173:775, 1971

    Google Scholar 

  43. Bushkin FL, Neustein DL, Parker TH, Woodward ER: Nissen fundoplication for reflux peptic eosphagitis.Ann Surg 185:672, 1977

    Google Scholar 

  44. Nicholson DA, Nohl-Oser HC: Hiatus hernia: A comparison between two methods of fundoplication by evaluation of the long-term results.J Thorac Cardiovasc Surg 72:938, 1976

    Google Scholar 

  45. Olnich HM, Weens HS, Rogers JV Jr: Radiological diagnosis of retained surgical sponges.JAMA 159:1525, 1955

    Google Scholar 

  46. Cain GD, Moore P Jr, Patterson M: Bezoars—A complication of the postgastrectomy state.Am J Dig Dis 13:801, 1968

    Google Scholar 

  47. Szemes GC, Amberg JR: Gastric bezoars after partial gastrectomy. Report of 5 cases.Radiology 90:765, 1968

    Google Scholar 

  48. Segal AW, Bank S, Marks IN, Ribenstein ZM: Bezoars occurring in the gastric remnant after gastrectomy.S. Afr Med J 44:1176, 1970

    Google Scholar 

  49. Pollard H, Block G: Rapid dissolution of phytobezoar by cellulase enzyme.Am J Surg 116:933, 1968

    Google Scholar 

  50. Wirthlin LS, Malt RA: Accidents of vagotomy.Surg Gynecol Obstet 135:913, 1972

    Google Scholar 

  51. Markowitz AM: Internal hernia after gastrojejunostomy.Surgery 49:185, 1961

    Google Scholar 

  52. Buckberg GD: Acute obstruction of the efferent loop after gastrectomy.Am J Surg 113:682, 1967

    Google Scholar 

  53. Quinn WF, Gifford JH: The syndrome of proximal jejunal loop obstruction following anterior gastric resection.Calif Med 72:18, 1950

    Google Scholar 

  54. Burhenne HJ: The iatrogenic efferent-loop syndrome.Am J Roentgenol Radium Ther Nucl Med 91:942, 1968

    Google Scholar 

  55. Golden R: Functional obstruction of efferent loop of jejunum following partial gastrectomy.JAMA 48:721, 1952

    Google Scholar 

  56. Bodon GR, Ramanath HK: The gastrojejunostomy efferent loop syndrome.Surg Gynec Obstet 134:777, 1972

    Google Scholar 

  57. Petterson S, Wallensten S: Leakage at suture lines after partial gastrectomy for peptic ulcer.Acta Chir Scand 135:229, 1969

    Google Scholar 

  58. Rudko M, Price WE: Duodenal stump perforation.J Okla State Med Assoc 58:337, 1965

    Google Scholar 

  59. Rudko M, Price WE Duodenal stump perforation.J Okla State Med Assoc 58: 337, 1965

    Google Scholar 

  60. Samuel E, Duncan JG, Philip T, Sumerling MD: Radiology of the postoperative abdomen.Clin Radiol 14:133, 1963

    Google Scholar 

  61. Jordan GJ Jr, Walker LL: Severe problems with gastric emptying after gastric surgery.Ann Surg 177:660, 1973

    Google Scholar 

  62. Donovan I, Alexander-Williams J: Postoperative gastric retention and delayed gastric emptying.Surg Clin North Am 56:1413, 1976

    Google Scholar 

  63. Carter TM, Martel W: Contraction of the gastric antrum following a long-term gastrojejunostomy—Report of 2 cases.Radiology 91:514, 1968

    Google Scholar 

  64. Hajdu N, Hyde I, Riddell V: Antro-pyloric hypertrophy in patients with longstanding gastroenterostomies—A study of 13 cases.Br J Radiol 41:49, 1968

    Google Scholar 

  65. Marshal SF, Knud-Hansen J: Gastrojejunal, pelvic and gastrocolic fistula.Ann Surg 145:770, 1957

    Google Scholar 

  66. Schwartz SI, Lillehei RC, Shires GT, Spencer FC, Storer EH:Principles of Surgery, 2d Ed. New York: McGraw-Hill, 1969

    Google Scholar 

  67. Thoeny RH, Hodgson JR, Scudamore HH: The roentgenologic diagnosis of gastrocolic fistulas.Am J Roentgenol Radium Ther Nucl Med 83:876, 1960

    Google Scholar 

  68. Wychulis AR, Priestley JT, Foulk WT: A study of 360 patients with gastrojejunal ulceration.Surg Gynecol Obstet 122:89, 1966

    Google Scholar 

  69. Passaro E, Jr, Gordon HE, Stabile BE: Marginal ulcer: A guide to management.Surg Clin North Am 56:1435, 1976

    Google Scholar 

  70. Schatzki R: The significance of rigidity of the jejunum in the diagnosis of postoperative jejunal ulcers.Am J Roentgenol Radium Ther Nucl Med 103:330, 1968

    Google Scholar 

  71. Christoforidis AJ, Nelson TW: Radiological manifestations of ulcerogenic tumors of the pancreas—the Zollinger-Ellison syndrome.JAMA 198:97, 1966

    Google Scholar 

  72. Isenberg JI, Walsh JH, Grossman MI: Zollinger-Ellison Syndrome.Prog Gastro 65:140, 1973

    Google Scholar 

  73. van Heerden JA, Bernatz PE, Rovelstad RA: The retained gastric antrum—Clinical considerations.Mayo Clin Proc 46:25 1971

    Google Scholar 

  74. Burhenne JH: The retained gastric antrum. Preoperative roentgenologic diagnosis of an iatrogenic syndrome.Am J Roentgenol Radium Ther Nucl Med 101:459, 1967

    Google Scholar 

  75. Beneventano TC, Glotzer P, Messinger NH: Retained gastric antrum.Am J Gastroenterol 59:361, 1973

    Google Scholar 

  76. Safaie-Shirazi S, Chaudhuri TK, Condon RE: Visualization of isolated retained antrum by using technetium 99-m.Surgery 73:278, 1973

    Google Scholar 

  77. Seam WB: Prolapsed gastric mucosa through a gastrojejunostomy.Am J Roentgenol Radium Ther Nucl Med 110:304, 1970

    Google Scholar 

  78. LeVine M, Boley SI, Mellins HZ, Schwartz SS: Gastrojejunal mucosal prolapse.Radiology 80:30, 1963

    Google Scholar 

  79. Tanner NC: Personal observations and experiences in the diagnosis and management of ulcert disease and disabilities that follow peptic ulcer operations.Surg Clin North Am 56:1349, 1978

    Google Scholar 

  80. Hardy JD: Problems associated with gastric surgery—A review of 604 consecutive patients with annotation.Am J Surg 108:699, 1964

    Google Scholar 

  81. Jordan JL, Angel RT, Mulhaney JS, Willms RK: Treatment of the postgastrectomy dumping syndrome with a reverse jejunal segment interposed between the gastric remnants and the jejunum.Am J Surg 106:451, 1963

    Google Scholar 

  82. Stalsberg H, Faksdal S: Stomach cancer following gastric surgery for benign conditions.Lancet 2:1175, 1971

    Google Scholar 

  83. Feldman F, Seaman WB: Primary gastric stump carcinoma.Am J Roentgenol Radium Ther Nucl Med 115:257, 1972

    Google Scholar 

  84. Moffat RC, Berkas EM: Bile esophagitis.Arch Surg 91:963, 1965

    Google Scholar 

  85. Clark SD, Penry JB, Ward P: Oesophageal reflux after abdominal vagotomy.Lancet 2:824, 1965

    Google Scholar 

  86. Dagradi AE, Stempieri SJ, Seifer HW, Weinberg JA: Terminal esophageal (vestibular) spasm after vagotomy.Arch Surg 85:955, 1962

    Google Scholar 

  87. Herrington JL, Sawyers JL, Whitehead WA: Surgical management of reflux gastritis.Ann Surg 180:526, 1974

    Google Scholar 

  88. Barichello AW, Pimblett T, Dyck FJ, McFadden D: Rupture of the stomach following oxygen therapy by nasal catheter.Can Med Assoc J 98:855, 1968

    Google Scholar 

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut, USA

    Bernard S. Jay & Morton Burrell M.D.

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  1. Bernard S. Jay
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  2. Morton Burrell M.D.
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Jay, B.S., Burrell, M. Iatrogenic problems following gastric surgery. Gastrointest Radiol 2, 239–257 (1977). https://doi.org/10.1007/BF02256501

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