A rare case of internal herniation with retrograde jejunogastric intussusception into the stomach

Abstract

Jejunogastric intussusception (JGI) is a rare long‐term complication of Billroth II gastrectomy. It presents potentially lethal complication of gastrectomy or gastrojejunostomy which can occur any time after a gastric operation. Delayed diagnosis can lead to high morbidity and even mortality. Prompt surgical intervention is mandatory after early diagnosis. Endoscopy and abdominal computed tomography (CT) scanning are the main diagnostic tools. For gastric surgery patients who later experience sudden onsets of epigastric pain, vomiting, or subsequent hematemesis, JGI should be considered. A 77‐year‐old man who had a Billroth II gastrectomy 30 years prior to admission presented to our emergency department due to multiple episodes of epigastric colicky pain and hematemesis. He underwent esophagogastroduodenoscope and an abdominal CT scan. We provided a systemic image description of a rare case of internal herniation with retrograde JGI into the stomach. The patient received emergent laparotomy and resection of the efferent loop of the jejunum with the gangrenous segment. He was discharged 10 days after admission. JGI is a rare but potentially fatal disease. Early diagnosis and surgical treatment are important to avoid subsequent high mortality.