Anastomotic ulcer: an unusual cause

ABSTRACT

A case of recurrent stomal ulcer is reported due to retained excluded antral mucosa during a Bancroft procedure. The diagnosis was suspected from the severity of the ulcer diathesis, and the elevated basal acid secretion despite previous trans-thoracic vagotomy and repeated gastric resection. It was confirmed by finding retained antral mucosa in the "duodenal" stump, and a normal pancreas at operation; and by a marked fall in acid levels following antral excision.The diagnosis and treatment of this condition are discussed. Continual awareness of retained excluded antrum as a cause of stomal ulcer will decrease the frequency of this complication and ensure prompt diagnosis and treatment when it occurs (AU)