Roentgenologic aspects after (total) gastrectomy for malignant tumours

Pre-operatively, radiological examination is important for the diagnosis of malignant tumours in the stomach. Postoperatively, it can be used to demonstrate the state of the anastomosis and possible defects of the suture, for the early recognition of recurrences or other abnormalities, and for the diagnosis of reflux oesophagitis and the dumping syndrome. Changes in the oesophagus following various types of reconstruction were examined, both clinically and radiologically, in 40 patients who had had gastrectomies. Following jejunal interposition with a proximal end-to-side anastomosis and a long blind segment, there may be reflux into the oesophagus, but symptoms of reflux oesophagitis only occur if there is also duodeno-jejunal reflux. Patients with a Rouc loop show few symptoms, while the worst radiological and clinical results were achieved with a double-barrelled jejunal loop, despite a low anastomosis. (orig.)