Jejunogastric Intussusception

Czerniak, Abraham; Bass, Arie; Bat, Leon; Shemesh, E; Avigad, Itamar; Wolfstein, I

doi:10.1001/archsurg.1987.01400220100019

Cited by 26 publications

(13 citation statements)

References 21 publications

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“…8 The most important diagnostic tool is upper gastrointestinal endoscopy for direct visualization of the anastomosis and intraluminal lesions. 10 CT scans are also useful. 11 A plain abdominal film occasionally shows a mass lesion in the left upper abdominal quadrant, representing small bowel intussusception into the stomach.…”

Section: Discussionmentioning

confidence: 99%

Retrograde jejunogastric intussusception: A case report and review of the literature

Loi

Huang

Chen

et al. 2017

Asian Journal of Surgery

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Retrograde jejunogastric intussusception (JGI) is a rare but potentially fatal complication after previous gastrectomy or gastric bypass surgery. Because of the prevalence of bariatric surgery, the number of cases of postoperative intussusception has increased markedly. Here, we present the case of a patient with retrograde jejunogastric intussusception, having a previous history of subtotal gastrectomy and gastrojejunostomy for peptic ulcer disease. Correct preoperative diagnosis was made by plain abdominal film, upper gastrointestinal series, computed tomographic scan, and esophagogastroduodenoscopy. The diagnosis was confirmed by laparoscopic examination.

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Section: Discussionmentioning

confidence: 99%

Retrograde jejunogastric intussusception: A case report and review of the literature

Loi

Huang

Chen

et al. 2017

Asian Journal of Surgery

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“…In the chronic recurrent type with a wide stoma, spontaneous reduction may occur with relief of symptoms. Upper gastrointestinal endoscopy is highly diagnostic 13 but where it is not diagnostic, as in the present case, ultrasonography 14 barium studies and CT scan 15 are helpful. Acute postoperative JGI (clinical type 3) usually resolves spontaneously with drip and suction as the mucosal edema subsides.…”

Section: Discussionmentioning

confidence: 65%

Jejunogastric Intussusception: A Rare Cause of Life-Threatening Hematemesis

Bakhsh¹,

Igbinovia²,

Egere³

et al. 1997

Ann Saudi Med

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K Bakhsh, A Igbinovia, JU Egere, A Ali, MS Butt, AM Rehan, Jejunogastric Intussusception: A Rare Cause of LifeThreatening Hematemesis. 1997; 17(3): 328-330 An intussusception is an invagination of a segment of gastrointestinal tract into an adjacent one. It is a rare cause of intestinal obstruction in adults, compared to children, in whom it is second only to appendicitis as a cause of abdominal emergency.1,2 Whereas intussusception is usually idiopathic in children, in adults an underlying pathology is demonstrable in over 90% of cases.3 The intussusception is located in the large or small intestine in 90% of cases and in the stomach or surgically created stomas in the remaining 10%. 4 Jejunogastric intussusception (JGI) is a very difficult condition to diagnose. Its rarity necessitates a high index of suspicion if cases, particularly the chronic recurrent type, are not to be missed.We report a case of acute JGI presenting with severe hematemesis. Case ReportA 60-year-old Saudi man presented with abdominal pain and vomiting, which had begun suddenly two hours before admission. Repeated vomiting was followed by hematemesis. The only significant past history was an operation for duodenal ulcer in India 16 years previously, following which he had remained symptom free. The type of operation was not known.On examination, the patient looked ill and anxious. The pulse was initially 75/minute and the blood pressure 150/80. Abdomen was soft, not distended, but tender in the epigastrium. No mass was felt. There were no signs of chronic liver disease. Following further hematemesis the man's blood pressure dropped to 80/50 and he went into shock. After initial resuscitation with six units of blood, intravenous vitamin K and cimetidine, an urgent upper gastrointestinal endoscopy was performed. The stomach revealed a big clot of blood and reddish-brown mass lined by whitish streaks. The antrum ended blindly. The blood clot was not disturbed because of fear of precipitating further bleeding. No specific diagnosis could be made at this stage.The results of investigations were hemoglobin 14. The following day the patient vomited more foul-smelling material mixed with altered blood. Upper gastrointestinal barium study revealed a long tubular filling defect in the antral region of the stomach, showing valvulae conniventes lined with contrast ( Figure 1). A diagnosis of jejunogastric intussusception was made.Upon operating, it was found that a loop of small intestine was intussuscepting into the stomach through an antecolic anastomosis. The lead point was a hypertrophied lymph node with an adhesive band.The intussusception was reduced manually. A gastrostomy did not reveal any stomal ulcer. The bleeding was presumed to be from congested mucosa. Histology of the excised lymph node showed only reactive lymphadenitis. DiscussionJejunogastric intussusception is a rare complication of gastrojejunostomy, Billroth II gastrectomy and Roux-en-Y gastrectomy.

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“…It directly visualizes the intussuscepted gut in stomach in acute cases. In chronic JGI, the condition can be precipitated during endoscopy by directing a jet of water to the gastrojejunostomy stoma thereby confirming the diagnosis [11]. It can also reduce the intussusception occasionally in early cases.…”

Section: Discussionmentioning

confidence: 97%

Jejunogastric intussusceptions

et al. 2010

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Zusammenfassung. Grundlagen: Jejunogastrische Intussuszeption ist selten. Wir fassten 3 Fälle zusammen, die sich während eines Monats bei uns präsentierten. Diese Studie sollte die Rolle der Sonographie in der Diagnostik und im Management (i.e. Wahl des chirurgischen Vorgehens) untersuchen.Methodik: Fallbericht und Literaturübersicht. Ergebnisse: Die Patienten präsentierten sich mit Schmerzen, Bluterbrechen, Oberbauchtumor, Zustand nach Vagotomie und Gastrojejunostomie vor mehr als 10 Jahren wegen Magenulkus. Die Sonographie war in allen Fällen diagnostisch erfolgreich.Schlussfolgerungen: Die Sonographie ist höchst aussagekräftig und Zeit-und Ressourcen-sparend in der Diagnose der jejunogastrischen Intussuszeption und zum Planen des Vorgehens. Dieses ist die Resektion und Fixation der Anastomose, um ein Wiederauftreten zu verhindern.Schlüsselwörter: Jejunogastrische Intussuszeption, Magenchirurgie, Sonographie, Ulkustherapie.Summary. Background: Jejunogastric intussusceptions are rare. We reviewed three cases presented to us in a span of one month. This study has been conducted to assess the role of ultrasonography and to determine the type of surgery we should perform in such cases.Methods: Case report and literature review.Results: The cases presented with the classic triad of pain, hematemesis, and upper abdominal mass, with a history of vagotomy and gastrojejunostomy more than a decade ago for gastric ulcer. Ultrasonography was diagnostic in all. The diagnosis was confirmed on laparotomy. All three cases required resection anastomosis, as the bowels were already gangrenous. One case required revision surgery.Conclusions: Ultrasonography is diagnostic and can save time and resources for out of hour CT=Endoscopy. Early operation is recommended. Reduction of the intussusceptions, viability assessment and if require resection anastomosis with fixation to prevent recurrence are the standards of care.

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Jejunogastric Intussusception

Cited by 26 publications

References 21 publications

Retrograde jejunogastric intussusception: A case report and review of the literature

Retrograde jejunogastric intussusception: A case report and review of the literature

Jejunogastric Intussusception: A Rare Cause of Life-Threatening Hematemesis

Jejunogastric intussusceptions

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