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Mechanical gastric outlet obstruction after continent urinary diversion
C N Barrilleaux1, R C Leib, I M Thompson
1Department of Internal Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas 78234-6200.
The Journal of Urology
|December 1, 1987
Summary
Complex urinary diversions can cause complications. This case highlights mechanical gastric outlet obstruction after a continent urinary diversion, which resolved with reservoir drainage, emphasizing the need for consideration of reservoir distension effects.
Area of Science:
- Urology
- Surgical Complications
- Gastroenterology
Background:
- Complex continent urinary diversions are surgical procedures to restore urinary continuity.
- These diversions can be associated with various postoperative complications.
- Gastric outlet obstruction is a rare but serious complication.
Observation:
- A patient developed mechanical gastric outlet obstruction post-continent urinary diversion using distal ileum and ascending colon.
- The obstruction was characterized by symptoms related to impaired gastric emptying.
- The condition was diagnosed and managed conservatively.
Findings:
- Adequate drainage of the urinary reservoir led to the resolution of gastric outlet obstruction.
- This suggests a mechanical effect from the distended urinary reservoir on adjacent gastrointestinal structures.
- The ileum and colon segments used for diversion can exert pressure on the stomach or duodenum.
Implications:
- Clinicians must consider mechanical effects from distended urinary reservoirs in patients undergoing continent urinary diversion.
- Early recognition and management of such complications are crucial for patient outcomes.
- This case underscores the importance of a multidisciplinary approach in managing complex urological reconstructions.