Difficult Anastomosis” Inemergency Abdominal Surgery

Abstract

The presented case is interesting since despite aggravated oncoanamnesis (mammectomy, Kenyu-Miles surgery),comorbid pathologies (diabetes mellitus, atrial fibrillation)and major surgical intervention (resected 1.5-meter intestine)“end-to-end” manual anastomosis between the lower hori-zontal segment of duodenum and jejunum was performed to85 years old patient. Patient was admitted as an emergencycase complaining about severe abdominal pain. Contrast CTrevealed intestinal obstruction on the level of the small bow-el. Emergency laparotomy revealed small bowel segmentnecrosis due to the loop’s 3600 rotation. There was no je-junum left proximal to the bowel necrosis, therefore mobiliza-tion of Treitz ligament till the lower horizontal segment of theduodenum with farther duodeno-jejunoanastomosis wasperformed. Anastomosis failure did not occur and the pa-tient was discharged from the clinic in a recovered condition.