Gastric Outlet Obstruction Following Postoperative Adhesions From Open Cholecystectomy In A Nigerian Female: A Case Report And Review Of Literature

Gastric outlet obstruction (GOO) is caused by benign or malignant conditions. Benign causes are commoner in patients below 40 years of age while malignant causes are commoner above this age. Cicatrization and edema from chronic duodenal ulceration is the commonest benign cause in our environment (50-65%), while carcinoma of the head of pancreas is the commonest malignant cause. GOO from postoperative adhesions is uncommon. We present a 62-year-old female who was seen with features of GOO from postoperative adhesions following an open cholecystectomy in our facility. A barium meal and follow-through confirmed the clinical impression of GOO. She had adhesiolysis and a prophylactic gastrojejunostomy at laparotomy with satisfactory results. Laparoscopic cholecystectomy is the way to go as this may not have been attended by this complication. Conclusion: This case has highlighted the rarity of GOO from adhesions following open cholecystectomy and the usefulness of barium meal and follow-through in areas where upper gastrointestinal endoscopy is unavailable to confirm the diagnosis. Laparoscopic cholecystectomy may have prevented this complication if it was possible in this center.