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Intussusception after Roux-en-Y gastric bypass
Derek Stephenson1, Rena C Moon1, Andre F Teixeira1
1Department of Bariatric Surgery, Orlando Regional Medical Center & Bariatric and Laparoscopy Center, Orlando Health, Orlando, Florida.
Summary
Jejuno-jejunal intussusception after Roux-en-Y gastric bypass (RYGB) is rare. While reduction alone is safe, imbrication of the jejuno-jejunal anastomosis may offer a more effective treatment to prevent recurrence.
Area of Science:
- Bariatric Surgery
- Gastrointestinal Surgery
- Surgical Complications
Background:
- Jejuno-jejunal (J-J) intussusception is a rare complication following Roux-en-Y gastric bypass (RYGB).
- Clinical presentation is nonspecific, delaying diagnosis and potentially leading to obstruction and bowel necrosis.
- A definitive treatment strategy for post-RYGB intussusception remains to be established.
Purpose of the Study:
- To describe the clinical presentation of patients experiencing intussusception after RYGB.
- To evaluate the outcomes of different treatment modalities for this rare complication.
Main Methods:
- A retrospective review of a prospectively collected database.
- Analysis of 12 patients who underwent laparoscopic RYGB between January 2003 and January 2013 and presented with intussusception.
- Review of diagnostic methods (CT scan, intraoperative findings) and treatment approaches (reduction, resection/revision, imbrication/plication).
Main Results:
- 11.7% of patients presented with abdominal pain; 8.3% with nausea/vomiting.
- Diagnosis occurred at a mean of 24.9 months post-RYGB.
- Treatments included reduction (58.3%), resection/revision (16.7%), and imbrication/plication (25.0%). One patient treated with reduction experienced recurrence.
Conclusions:
- Reduction of jejuno-jejunal intussusception after RYGB is safe and effective in the short term.
- Imbrication/plication of the jejuno-jejunal anastomosis may be a more effective treatment to reduce the risk of recurrence.
- All patients achieved good outcomes at a mean follow-up of 12.7 months.
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