Vascularized jejunal pedicle graft for duodenal reconstruction in a cat: Case Report

Reconstruction of large defects of the proximal duodenum can be challenging, as sacrifice of this region requires biliary re-routing ± partial pancreatectomy, resulting in considerable morbidity. This article reports a novel method for duodenal reconstruction with long-term follow-up. The technique was performed after resection of a large enteric duplication cyst causing intestinal obstruction in a 1-year-old spayed female domestic short hair cat presented for vomiting. A 2.7 × 2.3 cm hemi-circumferential cyst involving the left duodenal wall, located adjacent and caudal to the major duodenal papilla, was identified. Following full-thickness resection with preservation of the pancreatic-duodenal artery and vein, the resulting defect was reconstructed with a vascularized jejunal pedicle graft harvested from the mid-jejunum. The donor site was closed with an end-to-end anastomosis. The pedicle graft retained complete viability, with no evidence of stricture or stenosis of the recipient region on follow-up imaging at 9 months post-operatively. This method may be considered for the effective repair of large mural defects in the duodenum.