Duodenal stump leakage and associated abscess and fistula following gastric carcinoma surgery: A Case Report

Introduction: Gastric carcinoma, a common gastrointestinal malignancy, is treated with gastrectomy, which may cause duodenal stump leakage (DSL).This rare complication can lead to abscess and fistula, increasing mortality.This case report examines a patient with recurrent DSL post-gastrectomy.Case Presentation: A 72-year-old male underwent total gastrectomy for gastric carcinoma.Six months post-surgery, he had abdominal pain and discharge.CT showed a perihepatic abscess and fistula from DSL. Conservative treatment with drainage, nutrition, and antibiotics initially succeeded.Symptoms recurred at 7 and 13 months, requiring revision surgery with an omental patch.No complications occurred during the one-year follow-up.Conclusion: DSL, occurring in 0.5-5% of gastrectomies, is linked to age, smoking, and surgical technique.Conservative management often works, but refractory cases need surgery.Smoking and high CRP were key risk factors.Conservative management may address DSL, but surgery is needed for refractory cases.Early risk assessment reduces complications.