Endoscopic Treatment of a Twisted Small Bowel Obstruction after Laparoscopic Proximal Gastrectomy with Double Tract Reconstruction

This paper reports a case of a twisted small bowel obstruction in a 74-year-old man that occurred after a double tract reconstruction (DTR) in a laparoscopic proximal gastrectomy (PG) for early gastric cancer. The patient had inadequate oral intake and reflux symptoms for 10 days after discharge. Imaging analysis revealed a narrowed small bowel with twists between the esophagojejunostomy and gastrojejunostomy sites. A fully covered stent was placed in the narrowed small bowel for 2 weeks. The patient was then discharged after stent removal without any dietary problems. The authors' experience shows that twisted small bowel after a DTR in PG can be treated by endoscopy.