Retrograde intussusception in pregnancy following Roux-en-Y gastric bypass: a case report

Area of Science:

• Gastroenterology
• Surgical Oncology
• Obstetrics

Background:

• Retrograde intussusception is a rare form of bowel invagination, typically occurring anterograde due to peristalsis.
• Roux-en-Y gastric bypass procedures can predispose patients to rare gastrointestinal complications.
• Pregnancy presents unique physiological challenges that can alter the presentation and management of surgical conditions.

Observation:

• A 23-year-old pregnant female (36 weeks gestation) presented with acute abdominal pain, nausea, and hematemesis.
• Symptoms were attributed to retrograde intussusception at the jejunojejunostomy anastomosis, occurring 3 years post-Roux-en-Y gastric bypass.
• Diagnosis was confirmed via CT scan and exploratory laparotomy.

Findings:

• Surgical resection of the affected jejunojejunostomy and proximal jejunal common channel was performed.
• A new jejunojejunostomy anastomosis was successfully reconstructed.
• The patient was discharged on postoperative day 9 with anticoagulation for superior mesenteric vein thrombosis.

Implications:

• This case underscores the rarity of retrograde intussusception in pregnant patients post-gastric bypass.
• Early diagnosis and surgical intervention are crucial for favorable outcomes in such complex cases.
• Further research is warranted to understand the specific risk factors and optimal management strategies.