Ischemic necrosis of proximal gastric remnant following subtotal gastrectomy with splenectomy.

Ischemic necrosis of the gastric remnant is a rare and serious complication of high subtotal gastrectomy, rarely of the distal resection of the stomach. The authors report one case after subtotal gastrectomy with splenectomy, review the literature about this subject, and suggest that in all procedures the surgeon must take full account of the variability of gastric blood flow. Conservative therapy of this complication with total parenteral nutrition is proposed.