VS 01 - BN Chronic loop gastrojejunostomy volvulus masquerading as a Crohn’s stricture

Abstract Background A video presentation of a case of chronic loop gastrojejunostomy volvulus masquerading as a Crohn's stricture. Method 61 year old female with a previous loop gastrojejunostomy and subsequent ileocaecal resection for Crohn's related pyloric stenosis and terminal ileal stricture. Acute worsening of post-prandial pain and vomiting 5 years later, re-investigation revealed a stenosed gastrojejunostomy thought to be Crohn's related. Results Intraoperative volvulus of the gastrojejunostomy was demonstrated related to traction forces resulting in the migration of the duodeno-jejunal flexure to the right of midline. The gastrojejunostomy was revised to a Roux-en-Y configuration with relief of mechanical obstruction. Conclusion An ileocaecal resection may create unexpected traction forces