Roux-en-Y duodenojejunostomy for surgical management of isolated duodenal obstruction due to chronic pancreatitis Himanshu Sharma, Sanjay Marwah, Priyanka.

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Roux-en-Y duodenojejunostomy for surgical management of isolated duodenal obstruction due to chronic pancreatitis Himanshu Sharma, Sanjay Marwah, Priyanka Singla, Amit Garg, Bittu Bhukkal International Journal of Surgery Case Reports Volume 31, Pages 209-213 (January 2017) DOI: 10.1016/j.ijscr.2017.01.008 Copyright © 2017 The Authors Terms and Conditions

Fig. 1 Endoscopy showing dilated first part of duodenum (D1) and smooth narrowing at D1 D2 junction. International Journal of Surgery Case Reports 2017 31, 209-213DOI: (10.1016/j.ijscr.2017.01.008) Copyright © 2017 The Authors Terms and Conditions

Fig. 2 Barium meal film showing dilated stomach (S) and first part of duodenum (D1). Second part of duodenum is not visualized. International Journal of Surgery Case Reports 2017 31, 209-213DOI: (10.1016/j.ijscr.2017.01.008) Copyright © 2017 The Authors Terms and Conditions

Fig. 3 CECT film showing mass lesion in the head of pancreas (P) along with dilated stomach (S). International Journal of Surgery Case Reports 2017 31, 209-213DOI: (10.1016/j.ijscr.2017.01.008) Copyright © 2017 The Authors Terms and Conditions

Fig. 4 Intra-operative photograph showing dilated first part of duodenum (D1) seen distal to prepyloric vein. The second part of duodenum is collapsed (arrow). S:Stomach, GB: Gallbladder. International Journal of Surgery Case Reports 2017 31, 209-213DOI: (10.1016/j.ijscr.2017.01.008) Copyright © 2017 The Authors Terms and Conditions

Fig. 5 CECT film showing dilated stomach (S), duodenal obstruction at junction of D2-D3 (arrow) with a cyst in head of pancreas (P). International Journal of Surgery Case Reports 2017 31, 209-213DOI: (10.1016/j.ijscr.2017.01.008) Copyright © 2017 The Authors Terms and Conditions

Fig. 6 MRI film showing dilated stomach (S) with duodenal obstruction at junction of D2-D3 (arrow). International Journal of Surgery Case Reports 2017 31, 209-213DOI: (10.1016/j.ijscr.2017.01.008) Copyright © 2017 The Authors Terms and Conditions

Fig. 7 Intra-operative photograph showing dilated duodenum up to junction of D2-D3 (arrow). P: Pancreas. International Journal of Surgery Case Reports 2017 31, 209-213DOI: (10.1016/j.ijscr.2017.01.008) Copyright © 2017 The Authors Terms and Conditions

Fig. 8 Intra-operative photograph showing side to end duodenojejunostomy between dilated second part of duodenum (D2) and Roux limb of jejunum (J). A small cystic mass is seen in the head of pancreas (P). International Journal of Surgery Case Reports 2017 31, 209-213DOI: (10.1016/j.ijscr.2017.01.008) Copyright © 2017 The Authors Terms and Conditions

Fig. 9 Post-operative barium meal film showing free flow of barium through anastomosis (arrow) with regressed dilatation of stomach (S) and duodenum. International Journal of Surgery Case Reports 2017 31, 209-213DOI: (10.1016/j.ijscr.2017.01.008) Copyright © 2017 The Authors Terms and Conditions