Grade V gastric injury after penetrating abdominal trauma. A case report
García de León OR, Facio Treviño JA, Fonseca Sada JI, Hernández Vázquez SE, Castellanos Villanueva DL, Muñoz Maldonado GE. Grade V gastric injury after penetrating abdominal trauma. A case report. Am J Med Surg. July 2021; 4(3). 1-5.
Background: A gastrojejunostomy is a surgical procedure that creates an anastomosis between the stomach and the jejunum without creating a separate limb for pancreatobiliary secretions is known as a Billroth II.1,2 There are several reasons to develop a gastrojejunostomy.3
Braun enteroenterostomy is an anastomosis between the afferent and efferent limbs, which is distal to a gastroenterostomy. It is designed to divert pancreatic juice and bile from the afferent limb, leading to decreased reflux into the stomach.4
Case presentation: A 60-year-old-male presented in the emergency room after being found on the street with a thorax and abdomen cut wound, abdominal evisceration, an altered state of consciousness. An emergency exploratory laparotomy was performed. On exploration, Grade V lesion was evidenced in the gastric antrum, for which it was decided to perform the Billroth 2 procedure in addition to Braun enteroenterostomy. The remainder of the abdomen was inspected and did not require intervention. There was no further bleeding, and hemostasis was obtained. The abdomen was closed immediately at the end of the surgery.
Discussion: Patients with these injuries (grades IV and V) often do not survive in hospital, so these extensive gastric wounds are rarely encountered.5 Grade IV injuries can usually be managed through partial gastrectomy.
Conclusion: We present this case to describe Billroth 2 gastrectomy with Braun enteroenterostomy as a repair alternative for gastric lesions.
Key words: Trauma, abdominal trauma, gastric injury.