JUNIPER PUBLISHERS-OPEN ACCESS JOURNAL OF HEAD NECK & SPINE SURGERY Abstract Roux-en-Y choledochojejunostomy is a common bile duct reconstruction operation, which has a good surgical effect, and has a low chance of bile leakage and bile duct stenosis. The main complications are bleeding, infection, anastomotic leakage and stress ulcer, but unclosed mesenteric foramen of small intestine after Roux-en-Y choledochojejunostomy is rare. Therefore, in this report, we reviewed a case of the clinical data, imaging findings, and surgical status of a patient with unclosed mesenteric foramen of small intestine of ten years after Roux-en-Y choledochojejunostomy and hope to provide a case reference for clinicians. Keywords: Roux-en-Y choledochojejunostomy Unclosed mesenteric foramen Surgery suture Introduction Roux-en-Y choledochojejunostomy has different complications in clinical [1,2], and it is rare to have a proximal unclosed mesenteric hiatus. In this case, t