Janež J, Romih J, Čebron Ž, Gavric A, Plut S, Grosek J. Intraluminal migration of a surgical drain near an anastomosis site after total gastrectomy: A case report. World J Clin Cases 2025; 13(12): 99229 [DOI: 10.12998/wjcc.v13.i12.99229]
Corresponding Author of This Article
Jurij Janež, MD, PhD, Assistant Professor, Surgeon, Surgical Oncologist, Department of Abdominal Surgery, University Medical Centre Ljubljana, No. 7 Zaloška Cesta, Ljubljana 1000, Slovenia. jurij.janez@kclj.si
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 26, 2025; 13(12): 99229 Published online Apr 26, 2025. doi: 10.12998/wjcc.v13.i12.99229
Intraluminal migration of a surgical drain near an anastomosis site after total gastrectomy: A case report
Jurij Janež, Jan Romih, Žan Čebron, Aleksandar Gavric, Samo Plut, Jan Grosek
Jurij Janež, Jan Romih, Žan Čebron, Jan Grosek, Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
Jurij Janež, Jan Grosek, Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia
Aleksandar Gavric, Samo Plut, Department of Gastroenterology and Hepatology, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
Author contributions: Janež J designed the research; Romih J collected the data; Romih J and Čebron Ž analyzed and interpreted the data; Romih J and Čebron Ž wrote the paper; Čebron Ž, Janež J, and Gavric A drafted the manuscript; Grosek J and Plut S critically revised the manuscript.
Informed consent statement: Our institution does not require ethical approval for publishing a case report. The patient provided written informed consent for the publication of this case report and any accompanying images prior to surgery.
Conflict-of-interest statement: The authors declare having no conflicts of interest related to this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jurij Janež, MD, PhD, Assistant Professor, Surgeon, Surgical Oncologist, Department of Abdominal Surgery, University Medical Centre Ljubljana, No. 7 Zaloška Cesta, Ljubljana 1000, Slovenia. jurij.janez@kclj.si
Received: July 17, 2024 Revised: November 29, 2024 Accepted: December 13, 2024 Published online: April 26, 2025 Processing time: 173 Days and 12.1 Hours
Abstract
BACKGROUND
Esophagojejunal anastomotic leakage (EJAL) is a severe complication following gastrectomy for gastric cancer, typically treated with drainage and nutritional support. We report a case of intraluminal drain migration near the esophagojejunal anastomosis (EJA), resulting in persistent drainage and mimicking EJAL after total gastrectomy.
CASE SUMMARY
A 64-year-old male underwent open total gastrectomy with Roux-en-Y reconstruction for gastric adenocarcinoma, with two silicone drains placed near the EJA. On postoperative day (POD) 4, the patient developed signs of peritonitis and sepsis, necessitating surgical re-exploration abscess drainage, peritoneal lavage, and drain repositioning. A contrast swallow study on POD 18 revealed rapid filling of the abdominal drain without extraluminal contrast collection. Persistent drainage prompted an upper gastrointestinal endoscopy on POD 59, which revealed approximately 5 cm of the drain within the esophagus, with the perforation site located 2 cm distal to the intact EJA. The drain was repositioned under endoscopic guidance. A repeat contrast radiograph on POD 67 demonstrated no evidence of extraluminal contrast extravasation or filling of the abdominal drain. The patient was subsequently discharged without further incident.
CONCLUSION
Intraluminal drain migration is a rare complication following gastric surgery but should be considered when persistent drainage occurs.
Core Tip: Intraluminal drain migration after abdominal surgery is an uncommonly reported complication that can mimic anastomotic leakage. We present a rare case of abdominal drain migration adjacent to an esophagojejunostomy following total gastrectomy. This report includes a literature review to briefly summarize the incidence, pathophysiology, and diagnostic approaches for intraluminal drain migration.
