A 50-year-old man undergoes subtotal gastrectomy with Billroth II reconstruction for gastric ulcer. On postoperative day 5, he develops sudden severe epigastric pain, fever, and peritonitis. Oral contrast CT shows contrast leaking from the duodenal stump. What is this complication?
- A Anastomotic leak at gastrojejunostomy
- B Acute pancreatitis
- C Duodenal stump blowout ✓
- D Afferent loop syndrome
Correct answer: C. Duodenal stump blowout
Explanation
Duodenal stump blowout (blowout) is a serious complication after Billroth II gastrectomy, presenting around day 5 with peritonitis and contrast leak from the duodenal stump. Afferent loop syndrome causes bilious vomiting without peritonitis. Anastomotic leak would involve the gastrojejunostomy. Pancreatitis presents with elevated amylase. The duodenal stump is the classic site of this leak.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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