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Arch Surg. 2003;138:456.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Answer: Biliopancreatic Limb Obstruction Resulting in Gastric Staple Line Dehiscence

Figure 1. Upper gastrointestinal series with oral contrast. The findings are normal, with no evidence of obstruction or extravasation of contrast.

Figure appears in full text version. Figure 1.

Figure 2. Computed tomographic scan of the abdomen with oral and intravenous contrast. Free fluid is shown in the abdomen. There is no extravasation of contrast.

Figure appears in full text version. Figure 2.

Laparoscopic reexploration of this patient revealed bilious free fluid in the abdomen. Examination of the gastrojejunostomy and enteroenterostomy revealed no leakage at these sites. However, the biliopancreatic limb was distended to twice the diameter of the alimentary limb, and fluid could not be passed manually from the biliopancreatic limb to the alimentary limb. The gastric remnant staple line was also found to be disrupted, apparently resulting from back-up pressure secondary to obstruction of the biliopancreatic limb. A new, more proximal side-to-side anastomosis between the gastrojejunal and biliopancreatic limbs was created after laparotomy to relieve the obstruction. The . . . [Full Text of this Article]

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