[Jejunogastric invagination as late complication of stomach resection]

It is reported on a gastroscopically diagnosed jejunogastric invagination that has occurred in a 68-year old male patient 24 years after a Billroth's operation of class II. This distress gave rise to serious acute symptoms in the abdominal region, accompanied by gastric haemorrhage and showed the picture of an incomplete high-seated milieu of the small intestine. Surgical intervention was not necessary due to the fact that spontaneous disinvagination was considered to be the result of conservative therapy. As revealed by a follow-up gastroscopic examination, carried out at a later date, an irregularly movable afferent jejunal loop had to be stated as to be present, which most likely repeatedly led to transitory invaginations, and recurring epigastric distress was induced as a result of this. Up to now there are no established conceptions on the pathogenesis of this rare complication after a Billroth's operation. The objective symptoms, endoscopic and radiodiagnostic signs as well as the procedure of therapy are discussed.