PMC6167024_01
Diagram of the initial modified Puestow procedure.
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Eight years later in 1992, the patient underwent a distal pancreatectomy, splenectomy, and cholecystectomy with modified Puestow procedure for symptoms of radiating epigastric pain, nausea, and vomiting typically lasting for 1 week and occurring three to four times per year (Fig. 1).
Computed tomography image showing two substantial calcifications in the pancreatic remnant and their measured size. Note the absence of the spleen in the left upper quadrant.
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On computed tomography scan, significant calcification in the right-sided pancreatic remnant was present (Fig. 2).
Diagram of the completion pancreaticoduodenectomy procedure. DJ, duodenojejunostomy; HJ, hepaticojejunostomy, JJ, jejunojejunostomy.
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Trietz (Fig. 3).