Jejunal limb obstruction caused by a cholesterol stone 15 years after a total gastrectomy and 20 years after a cholecystectomy: Report of a case

We present herein the rare case of a 74-year-old woman found to have jejuna l limb obstruction caused by a cholesterol stone 15 years after a total gas trectomy with Rouxen-Y anastomosis, and 20 years after a cholecystectomy. T he patient complained of repeated episodes of upper abdominal distress on t hree separate occasions over a period of 20 months, and jejunal limb obstru ction was diagnosed by abdominal computed tomography scanning and Tc-99m sc intigraphy, Surgery revealed a stone incarcerated in the jejunal limb, wher e the anastomosis had become slightly stenotic. The removed stone was 3.5 c m in diameter and was subsequently demonstrated to be a cholesterol stone b y chemical analysis. This report is thought to be the first to describe jej unal limb obstruction caused by a gallstone incarcerated in the jejunal lim b after a total gastrectomy in a patient with a history of cholecystectomy.