Systemic steroid application for treatment of edematous anastomotic stenosis following delta-shaped anastomosis in laparoscopic distal gastrectomy: a case report

摘要

Representative images before systematic steroid treatment. a Computed tomography (CT) scans on postoperative day 9. The yellow arrowhead indicates the anastomotic part. b Endoscopy showing extreme swelling, like a polyp, in the duodenum on postoperative day 19. Yellow arrowheads indicate swelling. c Endoscopy showing the remaining portion of the stomach was edematous on postoperative day 19. d CT scan shows the wall of the anastomotic part was edematous, and swelling persisted on postoperative day 20. The yellow arrowhead indicates the anastomotic part. e Fluoroscopy revealing little contrast medium could flow into the duodenum on postoperative day 26. The yellow arrowhead indicates the contrast medium. f The quantity of contrast medium that could flow into the duodenum did not change after local injection of steroid on postoperative day 56. The yellow arrowhead indicates the contrast medium