Intussusception after Gastric Surgery

Abstract

Intussusception following gastric surgery is a rare postoperative complication. It may develop in clinical situations following gastroenterostomy, Billroth II gastric surgery with or without Braun anastomosis, or Roux-en-Y gastrojejunostomy. The patients may present with either an acute surgical emergency or with a chronic, relapsing form. The mortality may be up to 50 % in these cases if not treated appropriately, but little is known about the mechanism underlying the condition. Early diagnosis with a high index of suspicion and prompt treatment of the acute form are therefore important. Surgical reduction with laparotomy is mandatory, although definitive corrective and preventative measures have not yet been established.

Imaging Depiction of Retrograde Jejunogastric Intussusception

“…Upper GI endoscopic examination is diagnostic and has been proposed to therapeutic, by manual relocation of the bowel loops. In cases where strangulation and bowel ischemia exists, surgery is the only option, as the ischemic bowel has to be resected [2]. The widely accepted anatomical classification, proposed by Shackman in 1940, distinguishes three categories of jejunogastric intussusception: type I, afferent loop intussusceptions (antegrade): type II, efferent loop intussusception (retrograde); and type III, mixed type.…”

“…Early diagnosis is the key to prompt surgical intervention (within 48 h), which is the only method to reduce the high mortality rate (10-50 %) usually associated with this complication [2,3]. Following an initial description of the entity [4], numerable reports and only a few short series exist in the contemporary medical literature.…”

Jejunogastric intussusception as complication of gastric surgery

“…Eight years later, Lundberg described this rare complication in a patient who had BII gastric resection.6 After some time, individual cases and small series were published and about 200 described cases of postoperative JGI could be found in literature review up to now [4,[7][8][9][10][11]. Only 16 well described and documented cases of JGI were reported at the Mayo clinic in the period from 1907 to 1980 [9].…”

Jejunojejunal Intussusception: An Unusual Complication After Feeding Jejunostomy

“…These include polyps, lipoma, carcinoids, meckels' diverticulum, melanoma metastasis, lymphoma, suture lines, adhesions, submucosal bowel edema, intestinal dysmotility, long intestinal feeding tubes and chronic dilatation of bowel [2,3]. We present an unusual cause of intussusception after gastrectomy for gastric cancer.…”