Retrograde jejunogastric intussusception with jejunojejunal intussusception (double telescoping)
Manash Ranjan Sahoo1, Ved Bhaskar, Vedavyas Mohapatra
1Department of General Surgery, SCB Medical College, Cuttack, Odisha, India. manash67@gmail.com
BMJ Case Reports
|May 18, 2013
Summary
A rare case of jejunogastric intussusception occurred 15 years after gastric surgery. This condition, presenting as gastric outlet obstruction, required surgical intervention for gangrenous bowel resection and reconstruction.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Abdominal Surgery
Background:
- Gastric surgery, particularly gastrojejunostomy, can lead to delayed complications.
- Jejunogastric intussusception is a rare but serious complication following gastric surgery.
Observation:
- A 55-year-old woman presented with persistent gastric outlet obstruction.
- Physical examination revealed a palpable epigastric mass.
- Imaging studies (ultrasound and endoscopy) suggested retrograde jejunogastric intussusception.
Findings:
- Emergency laparotomy confirmed jejunogastric intussusception at a prior retrocolic gastrojejunostomy site.
- A 20 cm segment of jejunum was intussuscepted, with gangrene and perforation at its apex.
- Surgical management involved resection of the compromised jejunal segment and a Roux-en-Y anastomosis.
Implications:
- Prompt surgical intervention is crucial for managing jejunogastric intussusception to prevent catastrophic outcomes.
- Roux-en-Y anastomosis is an effective method for restoring gastrointestinal continuity after resection.
- Awareness of this complication is important for clinicians managing patients with a history of gastric surgery.
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