The syndrome of proximal jejunal loop obstruction following anterior gastric resection.

An occasional complication following subtotal gastric resection of the antiperistaltic, antecolic type is closed loop obstruction high in the intestine. Unless recognized and treated early, it causes death rather quickly. Prompt surgical intervention is life-saving. Symptoms which characterize the complication and distinguish it from other forms of high intestinal obstruction or stomal edema are (1) unrelenting epigastric or left upper quadrant pain and tenderness attended by clinical indication of shock, and (2) rather limited vomiting with absence of bile and small bowel contents in the vomitus. Five cases occurred in a series of some 500 anterior long loop anastomoses. In three cases the complication was not immediately recognized and the patients died. In the other two cases, recovery followed surgical intervention.