S146—Jejunojejunal intussusception after roux-En-Y gastric bypass: a case series of 34 patients

Poliakin, Lauren; Sundaresan, Naresh; Hui, Benedict; McKillop, Iain H.; Thompson, Kyle J.; Gersin, Keith S.; Kuwada, Timothy S.; Nimeri, Abdelrahman

doi:10.1007/s00464-020-07889-7

Cited by 9 publications

(5 citation statements)

References 23 publications

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“…The conservative approach is associated with decreased length of hospitalisation with a similar complication rate 13. However, retrospective analyses have demonstrated that reduction with or without enteropexy has higher recurrence rates when compared with resection and revision (12.5–50% versus 7.7–12.5%, respectively) 9 12 14. While encouraging, these results are insufficient to recommend any specific surgical approach given the power limitations.…”

Section: Discussionmentioning

confidence: 99%

Roux-en-Y retrograde intussusception: surgical reconstruction via sequential isoperistaltic side-to-side anastomoses

Chopko,

Sudhindran,

Stephens

2024

BMJ Case Rep

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Intussusception following Roux-en-Y gastric bypass is a rare, potentially life-threatening complication. Patients present with intermittent obstructive symptoms, and the diagnosis is made on imaging. Treatment is surgical considering the high likelihood of non-operative failure, strangulation, incarceration, perforation and concern for malignancy. We present the case of a woman in her 60s with a history of Roux-en-Y gastric bypass who presented with retrograde jejunojejunal intussusception at the distal Roux anastomosis. She proceeded to the operating room for complete anastomotic resection with reconstruction of three blind ends via two sequential isoperistaltic anastomoses. She progressed appropriately throughout her hospitalisation and was discharged on postoperative day 5 without recurrence. While intussusception in Roux-en-Y anatomy has been previously described, a literature review yielded sparse results in detailing its surgical correction. We highlight our unique surgical approach of jejunojejunal anastomotic resection with the creation of sequential isoperistaltic side-to-side anastomoses.

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Section: Discussionmentioning

confidence: 99%

Roux-en-Y retrograde intussusception: surgical reconstruction via sequential isoperistaltic side-to-side anastomoses

Chopko,

Sudhindran,

Stephens

2024

BMJ Case Rep

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“…Fang et al reported that a 3D CT examination of the small intestine could establish a reliable preoperative diagnosis by obtaining characteristic images of lipomas ( 15 ), even though small intestinal tumors, including lipomas, are difficult to detect early unless intussusception or intestinal obstruction occurs. Abdominal CT is essential in the diagnosis of intussusception, which can present as a “target sign” or a concentric circle-like presentation ( 16 ). A double intestinal canal sign can be seen when the long axis of intussusception is parallel to the scanned level, which has a high value in the preoperative examination of intussusception in adults ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Intussusception Related to Small Intestinal Lipomas: A Case Report and Review of the Literature

Wu²,

Sun³

2022

Front. Surg.

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IntroductionAdult intussusception is a rare disease that is difficult to diagnose and treat and is even rarer when it is caused by a lipoma of the small intestine. We reported a case of a small intestine lipoma combined with intussusception, which can guide people in future clinical work.Case PresentationA 51-year-old female was admitted to the hospital with “abdominal pain for 1 month.” Enhanced computed tomography (CT) of the abdomen suggested a lipoma in the left lower quadrant and a proximal intussusception. After excluding surgical contraindications, laparoscopic exploration was performed on the second day of admission, which showed a small amount of ascites in the abdominal cavity, a small intestine–small intestine-type intussusception about 20 cm from the ileocecal area and about 140 cm from the ileocecal area, and a mass of about 2×4 cm that was palpable by laparoscopic intestinal forceps, which was protruded into the intestinal cavity with a soft texture and sound mobility. A 5 cm-long incision was made above the mass to dissect into the abdomen layer by layer, and the diseased intestine was dislodged outside the abdominal cavity with oval forceps. The intestine was reduced by hand and observed for half an hour after reduction, and the blood circulation and peristalsis of the intestine were observed to be still sound. The intestine was dissected at 2 cm from the upper and lower margins of the mass using linear anastomosis to operate small intestine side-to-side anastomosis. The intestine was opened concurrently and closed with a linear anastomosis, using 3-0 absorbable thread to reinforce anastomosis intermittently. The procedure went smoothly, and the patient was discharged on the 5th postoperative day.ConclusionA small intestinal lipoma combined with small intestinal intussusception is rare in clinical practice and needs to be diagnosed by asking history detailedly, physical examination, and relevant ancillary tests such as abdominal CT. Laparoscopic-assisted small incision surgery for adult intussusception combines the advantages of laparoscopic surgery and laparotomy, operating simply and easily.

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“…A case series of 34 patients with jejuno‐jejuno intussusception describes laparoscopic or open operative management ranging from; ‘reduction only’, ‘reduction and enteropexy’, or ‘revision of jejunojejunostomy’. It found reoccurrence was likely in patients that underwent ‘reduction only’ 4 . The recurrence rate following ‘reduction only’, was as high as 100% in a series of 23 patients 5 .…”

Section: Figmentioning

confidence: 94%

“…It found reoccurrence was likely in patients that underwent 'reduction only'. 4 The recurrence rate following 'reduction only', was as high as 100% in a series of 23 patients. 5 In contrast, recurrence following 'reduction and enteropexy' was 26.5% in a study of 34 patients.…”

mentioning

confidence: 94%

Giant Jejuno‐gastric intussusception

Wong

Jacob

Sproston

et al. 2022

ANZ Journal of Surgery

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S146—Jejunojejunal intussusception after roux-En-Y gastric bypass: a case series of 34 patients

Cited by 9 publications

References 23 publications

Roux-en-Y retrograde intussusception: surgical reconstruction via sequential isoperistaltic side-to-side anastomoses

Roux-en-Y retrograde intussusception: surgical reconstruction via sequential isoperistaltic side-to-side anastomoses

Intussusception Related to Small Intestinal Lipomas: A Case Report and Review of the Literature

Giant Jejuno‐gastric intussusception

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