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[Anisoperistaltic Roux-en-Y reconstruction: rare cause for recurrent cholangitis after hepatic jejunostomy].

Stenosis of the hepatico-intestinal anastomosis after hepaticojejunostomy is a common cause for recurrent cholangitis. In the following report a patient's history of recurrent cholangitis after hepaticojejunostomy performed because of bile duct injury is presented. Preoperative imaging revealed a stricture of the hepatico-intestinal anastomosis and a massive dilatation of the Roux-en-Y loop, so that a draining disorder was assumed. Laparotomy showed an anisoperistaltic Roux-en-Y loop. When assessing the differential diagnosis of recurrent cholangitis after hepaticojejunostomy, anisoperistaltic reconstruction should be considered.

Anastomosis, Roux-en-Y↗

Roux-en-Y jejunostomy button in infants.

Establishing enteral feeding in high-risk infants with significant gastroesophageal reflux is a difficult challenge. Some patients are considered at very high risk for fundoplication and gastrostomy due to unstable medical conditions, dense upper-abdominal adhesions due to previous surgical procedures, or unfavorable anatomy. We describe a less invasive operation that provides jejunal feeding in a way that is safe, reliable, and convenient for the family.

Enteral Nutrition↗