# Gastric Outlet Obstruction Caused by Adhesion Between Remnant Greater Omentum and Lesser Omentum After Laparoscopic Transverse Colectomy

## TL;DR

A rare case of gastric outlet obstruction caused by adhesion between omental structures after laparoscopic colectomy is reported, with successful laparoscopic treatment.

## Contribution

Highlights a rare cause of gastric outlet obstruction and demonstrates the effectiveness of laparoscopic adhesiolysis for treatment.

## Key findings

- Computed tomography and endoscopy identified gastric outlet obstruction without intraluminal lesions.
- Laparoscopy revealed a band-like adhesion between the lesser and greater omentum causing obstruction.
- Laparoscopic adhesiolysis successfully relieved the obstruction and led to full recovery.

## Abstract

Postoperative adhesive small bowel obstruction is common after abdominal surgery, whereas gastric outlet obstruction (GOO) due to adhesions on the anterior surface of the stomach is extremely rare. We report an 81‐year‐old man who developed persistent vomiting shortly after laparoscopic transverse colectomy. Computed tomography revealed marked gastric dilatation with a beak sign at the pylorus, and upper gastrointestinal endoscopy showed stenosis from the lower gastric body to the gastric angle without intraluminal lesions. Emergency laparoscopy identified a band‐like adhesion between the lesser omentum and the remnant greater omentum crossing the anterior wall of the pyloric region and constricting the gastric outlet. Laparoscopic adhesiolysis with intraoperative endoscopic confirmation of patency relieved the obstruction, and the patient recovered uneventfully. This case highlights that omental–lesser omental bands should be considered as a differential diagnosis of early postoperative GOO after colorectal surgery and that laparoscopic adhesiolysis is a safe, minimally invasive treatment option.