Small Bowel Recurrent Intussusception Status Post Gastric Bypass

Intussusception is an uncommon problem in the adult population. Interestingly, it is also a rare late complication after gastric bypass. We report the case of a 73-year-old woman with a history of Roux-en-Y gastric bypass (RYGB) in 2004 complicated by jejunal intussusception in 2011 for which a small bowel resection was performed. The patient presented to the emergency department (ED) with intractable abdominal pain and nausea. The diagnosis of intussusception was made by abdominal CT scan. Initial laparoscopic reduction of the small bowel intussusception resulted in recurrence within the first 24 hours, and exploratory laparotomy with isoperistaltic small bowel anastomosis was then performed. Careful consideration in isolated reduction of uncomplicated recurrent small bowel intussusception is important. Our case describes an unsuccessful simple reduction in a patient with recurrent intussusception status post gastric bypass. While reduction is more conservative, in patients with recurrent intussusception, it is important to consider a reconstructive option such as resection and reconstruction of the jejunojejunostomy, as it appears to be associated with acceptable complication rates and the lowest risk of recurrence.