Work

Severe delayed gastric emptying combined with enteroparalysis after pancreaticoduodenectomy: a case report

Year: 2026

Type: article

Abstract: Background: Pancreaticoduodenectomy is an important surgical procedure for treating diseases of the pancreatic head, periampullary region, and related conditions. However, due to its extensive surgical scope, long duration, and involvement of complex digestive tract reconstruction, postoperative gastrointestinal dysfunction remains relatively common. Among these, delayed gastric emptying (DGE) is a common complication after pancreaticoduodenectomy, while the occurrence of severe DGE combined with enteroparalysis is relatively rare, and its diagnosis and treatment remain challenging. Case presentation: This article reports the case of a 69-year-old female patient who developed severe DGE complicated by intestinal paralysis after pancreaticoduodenectomy. The patient persistently experienced nausea, vomiting, and the inability to tolerate oral intake postoperatively. Although imaging studies suggested restricted passage at the gastrointestinal anastomosis, raising suspicion of obstruction, further laparoscopic exploration and gastroscopy revealed no definite mechanical obstruction. The patient received gastrointestinal decompression, nutritional support, internal environment management, and rehabilitation therapy. Enteral nutritional support was established through a jejunal feeding tube. After long-term comprehensive treatment, the patient's gastrointestinal function gradually recovered and eventually returned to oral intake. However, long-term follow-up showed that despite the recovery of gastrointestinal function, the patient still had a certain degree of decline in physical function and limited ability in activities of daily living. Conclusion: Severe delayed gastric emptying complicated by enteroparalysis after pancreaticoduodenectomy is a rare but clinically challenging gastrointestinal dysfunction. This case suggests that persistent postoperative gastrointestinal dysfunction may present with clinical features resembling mechanical obstruction, therefore requiring comprehensive assessment integrating imaging, endoscopy, and dynamic clinical changes.

Source: Frontiers in Surgery

DOI: 10.3389/fsurg.2026.1938654