Intussusception as a complication of partial gastrectomy. A case report

The causes of postgastrectomy syndrome are multiple and differ in their relative frequency. Among the more unusual is intussusception of the small bowel into the stomach or into the jejunojejunostomy. We describe a patient with acute retrograde intussusception of the efferent loop into the jejunojejunostomy occurring 14 months after partial gastrectomy with Billroth II anastomosis. Several theories regarding etiology are mentioned, among them functional causes, mechanical causes and derangements in stomal function. In our case, the circulatory derangement might possibly be a causal factor. The diagnostic problems are discussed, and the importance of early diagnosis is pointed out. A chronic form of intussusception is mentioned by several authors. Often the differential diagnosis is difficult, but epigastric pain, vomiting--ultimately of blood--and a palpable mass, constitute a classic triad. X-ray and endoscopy are supplementary aids to the diagnosis. Several types of operative treatment have been used, but no operative procedure seems to be fully effective as a safeguard against recurrence.