Intussusception of the appendix vermiformis in adults is an uncommon event. The combination of a mucinous cystadenoma with an intussuscepted appendix is extremely rare. Clinical symptoms are nonspecific; in most cases the correct diagnosis is not made before surgical exploration. With the radiologic and endoscopic presentation of a polypoid lesion of the caecum, a neoplasm is often considered. Endoscopic appendectomy or disinvagination by enema have been described. Thus the definitive therapy is surgery and depends on the histological diagnosis.
Summary.After GE or B II-anastomosis, an afferent or blind-loop syndrome is found in 0.5 to 20 %, as shown in the literature. There are several organic types and functional forms. Etiology, symptcmatology, diagnosis and therapy are discussed. In the acute form only immediate surgery is life saving. The smallest possible intervention should be preferred. In the chronic form, which depends upon the severity of the obstruction as well as its duration and may be associated with assimilation disturbances, the reconstruction of almost physiological conditions should be the aim. This means converting a B II-anastomosis to a B I-anastomosis with or without interposition of a jejunal segment.
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