In view of the fact that the logical treatment of stomach obstruction after gastrectomy is based on its pathogenesis, a brief review of the causative factors of this not infrequent complication seems justified.
Malfunction of the stoma may be of functional or organic origin.
There is a lack of agreement about the character of functional disturbances. One school of thought1,2 voices the belief that a spastic contraction of the efferent loop may be due to "pseudovagotomy," created by cessation of the sympathetic function. Conversely, another group3 holds the view that postoperative gastric atony may play a considerable part in retarded emptying of the stomach. Ravdin4 pointed out that a low colloid osmotic pressure, due to hypoproteinemia, may give rise to edema of the suture line and that the coincidental dehydration may mask the serum protein deficiency.
An organic obstruction may be created by one of the numerous
NARAT JK, CASELLA PA. Postgastrectomy Retention: Treatment by Second Gastroenterostomy. AMA Arch Surg. 1957;74(4):593–595. doi:10.1001/archsurg.1957.01280100111019
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