Jejunal intussusception at the jejunojejunostomy after laparoscopic total gastrectomy: A case report

Jejunal intussusception at the jejunojeunostomy after total gastrectomy with Roux-en-Y (RY) reconstruction is rare. We describe a case of jejunal intussusception at the jejunojeunostomy that developed in a 60-year-old woman who had undergone laparoscopic total gastrectomy with RY reconstruction for gastric cancer 4 years ago. The main presenting complaint was recurrent epigastric pain. Abdominal computed tomography showed a typical target sign suspected of antegrade intussusception into a blind loop at the jejunojeunostomy. We performed a laparoscopic operation, which revealed no intussusception or adhesions. We noted that the blind loop of the bilio-pancreatic limb was longer and expanded. We divided the blind loop at the distal side of the jejunojeunostomy and performed suture plication between the bilio-pancreatic limb and alimentary limb. Therefore, the appropriate length of the blind loop and the size of the jejunojeunostomy site should be carefully determined during RY reconstruction.