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DOI: 10.1055/a-1869-2680
Endoscopic marsupialization for severe candy cane syndrome: long-term follow-up
Candy cane syndrome (CCS) is a clinical condition that may occur after gastrectomy or gastric bypass when an excessively long or mispositioned blind jejunal loop proximal to the anastomosis is left in place. Preferential food passage in this loop results in symptoms such as fullness, pain, reflux, regurgitation, and postprandial vomiting.
Surgical resection of the dilated loop is technically complex, and morbidity limits its use in fragile patients. An endoscopic approach, using dedicated active magnets, has recently been shown to be effective in the medium-term.
We present here the case of a 71-year-old woman who underwent endoscopic treatment for the first time. She presented with intractable vomiting, food intolerance, and cachexia due to CCS after total gastrectomy for gastric cancer. Surgical treatment was not an option in such a high-risk patient, and she accepted treatment with a novel endoscopic approach using a double-magnet device followed by septotomy to marsupialize the blind loop. Her symptoms completely resolved and she regained weight.
We report here the patient’s clinical outcomes at 3 years, which suggest that endoscopic marsupialization for CCS is not only effective in the short term but also provides long-term clinical benefit.
Publication History
Received: 25 April 2022
Accepted after revision: 30 May 2022
Accepted Manuscript online:
03 June 2022
Article published online:
15 August 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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