Postoperative stomach and duodenum

A hypotonic biphasic contrast study proves or excludes ulceration and neoplasm in most instances. As in nonoperated patients, an initial radiologic examination may therefore serve as a screening method to determine whether endoscopy is indicated. After surgery artifacts may occur, which in some cases cannot be differentiated from malignant tumors or ulcer craters on a radiologic basis alone, although postoperative baseline studies may be helpful. In operated patients endoscopy is needed in a higher percentage than in nonoperated patients. Furthermore, in our experience endoscopy has proved to be superior to radiology in detecting small jejunal ulcers after a Billroth II resection. The possibility of recurrent carcinoma must be considered even after a short interval following gastric carcinoma surgery; however, if surgery was undertaken for a benign lesion, a higher rate of malignancy (primary gastric stump carcinoma) is not to be expected before a postoperative interval of at least 5 years.