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Intussusception at the jejunojejunal anastomosis five years after RYGB: A case report
Houssein Haidar Ahmad1, Rana Ibrahim2, Mustapha El Lakis3
1Houssein Haidar Ahmad, Surgery Department at Saint George Hospital-Hadath, Beirut, Lebanon.
Introduction:
Morbid obesity is a chronic disease with increasing global prevalence. Bariatric surgery is considered the most effective therapy for treating this condition. Like all surgical interventions, bariatric surgery carries certain complications. One of the rare complications is bowel intussusception following Roux-en-Y gastric bypass (RYGB).
Case Presentation:
A 46-year-old woman initially underwent sleeve gastrectomy for morbid obesity. Six years later, she was converted to RYGB due to gastroesophageal reflux disease. Five years after the conversion, she presented with recurrent abdominal pain. Investigations revealed intussusception at the jejuno-jejunal anastomosis. The patient underwent surgical revision of the jejuno-jejunostomy.
Discussion:
RYGB is one of the most common bariatric procedures. While it is highly effective for weight loss and improvement of comorbidities, it is associated with certain early and late complications, including the rare occurrence of intussusception. The underlying mechanism remains poorly understood, and the optimal surgical management is still debated. However, revision of the jejuno-jejunal anastomosis appears to offer the lowest recurrence rate.
Conclusion:
Intussusception after RYGB is a rare but serious complication that requires timely diagnosis and intervention. Several surgical options exist, with anastomotic revision showing the best outcomes in terms of recurrence and morbidity.
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