[Ischaemic stump necrosis after subtotal gastric resection - a rare complication]

The development of gastric stump necrosis after subtotal gastrectomy with Roux-en-Y loop reconstruction and splenectomy in a patient with gastric cancer is described. The patient's life could be saved by re-operations on the 12th and 50th postoperative day. Due to the patient's poor general condition and local peritonitis the gastric stump was removed and a catheter-jejunostomy was prepared by using the Roux-en-Y loop. The aboral end of the oesophagus was closed. To relieve the oesophageal stump a cervical mucoso-oesophagostoma was carried out. As the patient's general condition improved the reconstruction of the alimentary tract was performed by preparing a new Roux-en-Y loop oesophago-jejunostomy and by closing the mucoso-oesophagostoma.9 years after the operation the patient died of pulmonary metastases. The reasons for the delayed re-operation and the advantages of the cervical mucoso-oesophagostoma are explained.