AN ADULT CASE OF DUODENAL ANOMALY

a distal gastrectomy reconstruction using the Billroth II procedure wa s performed for epigastralgia and liver dysfunction caused by a duoden al anomaly in an adult. Hypotonic duodenography revealed the duodenum to be obliterated at the junction of the second and third portion, whi le the third portion was joined to the first portion. Endoscopic retro grade cholangiopancreaticography (ERCP) and ultrasonography showed a n ormal construction of the common bile and pancreatic ducts, as well as gallstones. To prevent ingested food from the stomach from entering t he obliterated second portion, a distal gastrectomy (Billroth II) was thus performed. The patient has remained asymptomatic for 4 years sinc e surgery. A distal gastrectomy reconstructed by a gastrojejunostomy i s thus considered to be an effective method for improving the symptoms caused by food stasis in the obliterated second portion of the duoden um.