Recurrent retrograde intussusception in patient with previous gastric bypass surgery

Retrograde intussusception (RI) is a rare long-term complication of gastric bypass surgery, which usually happens within the first few years after operation. The clinical presentation is vague with overlapping symptoms of bowel obstruction or ischemia. This is a case of a 37-year-old lady who presented with severe abdominal pain. She has background of Roux-en-Y gastric bypass surgery 23 years ago. She underwent emergency laparotomy, bowel resection and Roux-en-Y reconstruction due to finding of ischemic bowel segment. Unfortunately, she had recurrent presentation of RI after 6 months and similar operation was necessitated. She recovered well post-operatively, but there was no definitive cause established for the recurrence. While RI remains a rare diagnosis, clinicians should have high index of suspicion in encountering patients with acute abdomen post gastric bypass surgery. Early imaging is required for the diagnosis and surgical intervention is often warranted.