Unique Approach to Managing Hepatojejunal Anastomotic Stricture in a Patient With a Long Roux-en-Y Limb.
Publication Title
ACG Case Rep J
Document Type
Article
Publication Date
4-1-2026
Keywords
Roux-En-Y; endoscopic retrograde cholangiopancreatography; endoscopic ultrasonography; stricture.; washington; pshmc; spokane
Abstract
An anastomotic stricture is a frequent adverse outcome in patients with a Roux-En-Y hepaticojejunostomy. The patient described in this article developed a complicated hepato-jejunal anastomotic stricture with intrahepatic stones that could not be treated with standard balloon enteroscopic interventions due to a very long Roux limb. Thus, a duodenojejunostomy was created to allow access to the stricture and manage the intrahepatic stones. In this case, we convened a multidisciplinary panel of radiologists, surgeons, and interventional endoscopists to consider various therapeutic approaches. The various options were discussed with the patient as part of patient-centered medical decision-making. This patient case highlights the evolving and expanding role of endoscopic ultrasound-directed transenteric interventions for obtaining durable luminal access in patients with altered foregut anatomy, thus providing another avenue for therapeutic interventions which avoid surgery and associated morbidity.
Area of Special Interest
Digestive Health
Specialty/Research Institute
Gastroenterology
Specialty/Research Institute
Internal Medicine
Specialty/Research Institute
Hepatology
DOI
10.14309/crj.0000000000002068
