Management of a Marginal Ulcer Perforation in a Post-Gastrojejunostomy Patient - A Case Report

Abstract

Background: Complications following Gastrojejunal anastomosis are challenging. They frequently occur within the first week or several years after gastric bypass surgery. Anastomotic leakage, postoperative hemorrhage, marginal ulcers and stenosis are well-known complications following gastric bypass surgery but perforation of a marginal ulcer is a rare condition. Case presentation: We report a case of a 65-years-old male who presented to the emergency department with an acute abdomen. X-ray of erect abdomen revealed air under the diaphragm. An emergency laparotomy was planned which revealed a perforation at the jejunal side of gastrojejunostomy anastomosis which was done for gastric outlet obstruction secondary to peptic ulcer disease four years back. Primary closure with omental patch repair was done and the patient had a favorable outcome. Conclusion: This sheds light on the fact that in a patient with a gastrojejunal anastomosis, the index of suspicion for its perforation must be high if the patient presents with similar symptoms.