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June 1966

Infarction of the Gastric Remnant Following Subtotal Gastrectomy

Arch Surg. 1966;92(6):917-921. doi:10.1001/archsurg.1966.01320240105022

ALTHOUGH the blood supply to the stomach is unusually rich, it is neither limitless nor unassailable. In fact, the vascular supply to the cardioesophageal portion of the stomach is highly variable and may be seriously compromised by the unwary surgeon. Ischemic complications are rare, but frank necrosis of the stomach remnant following gastric resection can occur. Our experience with one such case demonstrates that certain surgical maneuvers can completely embarrass the vascular supply to the stomach. Analysis of this case and a discussion of other reported cases of damage following gastrectomy suggest that in all procedures the surgeon must take full account of the variability of gastric blood flow.

Report of Case  A 49-year-old French chef was admitted to The Roosevelt Hospital on Oct 1, 1962, for resection of a documented gastric ulcer.The patient gave a long history of peptic ulcer disease dating back 27 years to 1936. The