Jejunogastric intussusception: a case report of rare complication of gastrojejunostomy

Jejunogastric intussusception (JGI) is a rare complication of gastrojejunostomy surgery (<0.1% of cases), yet requires an urgent diagnosis. Mortality rate ranging from 10% to 50% based on delay in diagnosis and surgical intervention. Vomiting, abdominal pain and hematemesis are the most common symptoms. We report a 60 years old man admitted to the emergency department, complaining of epigastric pain and recurrent hematemesis for 3 days. Emergent upper GI endoscopy was done, and gastroenterologist reported a protruded edematous jejunal mucosa with bleeding, which formed a mass-like lesion. Abdominopelvic computed tomography scan also showed a target sign in favor of jejunal intussusception. Midline laparotomy and reduction of jejunal loop was performed and the patient was discharged without any further complications. In patients presented with hematemesis and abdominal pain and history of gastrectomy, JGI must considered as a possible cause because early diagnosis and treatment are necessary to prevent further complications.