Lu CY, Liu YL, Liu KJ, Xu S, Yao HL, Li L, Guo ZS. Differences in examination results of small anastomotic fistula after radical gastrectomy with afterward treatments: A case report . World J Clin Cases 2022; 10(21): 7609-7616 [PMID: 36157983 DOI: 10.12998/wjcc.v10.i21.7609]
Corresponding Author of This Article
Zhu-Shu Guo, MNurs, Chief Nurse, Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Central South University, No. 139 Renmin Middle Road, Furong District, Changsha 410011, Hunan Province, China. guozhushu@csu.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Chen-Yang Lu, Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Central South University, Changsha 410011, Hunan Province, China
Ya-Li Liu, Kui-Jie Liu, Shu Xu, Hong-Liang Yao, Lun Li, Zhu-Shu Guo, Department of General Surgery, The Second Xiangya Hospital of Central South University, Central South University, Changsha 410011, Hunan Province, China
Ya-Li Liu, Zhu-Shu Guo, Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Central South University, Changsha 410011, Hunan Province, China
Author contributions: Lu CY and Guo ZS performed the literature review and collected all the data related to the case report; Liu YL, Liu KJ, Xu S, Yao HL and Li L did the surgical appraisal; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhu-Shu Guo, MNurs, Chief Nurse, Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Central South University, No. 139 Renmin Middle Road, Furong District, Changsha 410011, Hunan Province, China. guozhushu@csu.edu.cn
Received: March 17, 2022 Peer-review started: March 17, 2022 First decision: May 9, 2022 Revised: May 18, 2022 Accepted: June 15, 2022 Article in press: June 15, 2022 Published online: July 26, 2022 Processing time: 115 Days and 21.5 Hours
Abstract
BACKGROUND
Gastrografin swallow, methylthioninium chloride test, and computed tomography (CT) are the main methods for postoperative anastomotic fistula detection. Correct selection and application of examinations and therapies are significant for the early diagnosis and treatment of small anastomotic fistulas after radical gastrectomy, which are conducive to postoperative recovery.
CASE SUMMARY
A 44-year-old woman underwent radical total gastrectomy for laparoscopic gastric cancer. The patient developed a fever after surgery. The methylthioninium chloride test and early CT suggested no anastomotic fistula, but gastrografin swallow and late CT showed the opposite result. The fistula was successfully closed using an endoscopic clip. The methylthioninium chloride test, gastrografin, and CT performed on different postoperative dates for small esophagojejunostomy fistulas are different. The size of the anastomotic fistula is an important factor for the success of endoscopic treatment.
CONCLUSION
The advantages and limitations of the diagnosis of different examinations of small esophagojejunostomy fistulas are noteworthy. The size of the leakage of the anastomosis is an important basis for selecting the repair method.
Core Tip: Gastrointestinal anastomotic fistula is one of the major complications after gastrointestinal anastomosis. The early diagnosis of small anastomotic fistulas and the choice of treatment are particularly important. We reported a case of a gastrointestinal anastomotic fistula that was not easily diagnosed at an early stage and discussed the advantages and limitations of the current main methods of examination in the context of medical imaging. In addition, we discussed the appropriate treatment for different anastomotic fistulas.
