Abstract
Introduction
Small bowel obstruction secondary to intussusception is a rare but important consequence of Roux-en-Y gastric bypass (RYGB).
Case report
A 37-year old female presented to the emergency department with abdominal pain. She had undergone RYGB 5-years previously for obesity. CT revealed a retrograde jejuno-jejunal intussusception. The intussusceptum was the common jejunal channel and the intussuscepiens was the jejunojejunostomy resulting in obstruction of both the alimentary and biliary limbs. The patient underwent laparotomy, small bowel resection and refashioning of the jejunojejunal anastamosis.
Conclusion
We report this case as it highlights both how a delay in diagnosis can occur and the importance of including this complication early in the differential diagnoses of any patient presenting with acute or chronic abdominal pain with a history of bariatric surgery. Retrograde intussusception is more common than previously thought and the incidence may increase as bariatric surgery is performed more frequently worldwide.
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References
Koppman JS, Li C, Gandsas A (2008) Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass: a review of 9,527 patients. J Am Coll Surg. 206:571–584
Podnos YD, Jimenez JC, Wilson SE et al (2003) Complications after laparoscopic gastric bypass: a review of 3464 cases. Arch Surg. 138:957–961
Azar T, Berger DL (1997) Adult intussusception. Ann Surg. 226:134–138
Marinis A, Yiallourou A, Samanides L et al (2009) Intussusception of the bowel in adults: a review. World J Gastroenterol. 15:407–411
Hocking MP, McCoy DM, Vogel SB et al (1991) Antiperistaltic and isoperistaltic intussusception associated with abnormal motility after Roux-en-Y gastric bypass: a case report. Surgery. 110:109–112
Simper SC, Erzinger JM, Mc Kinlay RD et al (2008) Retrograde (reverse) intussusception might not be such a rare problem: a single group’s experience of 23 cases. Surg Obes Relat Dis. 4:77–83
Van Steeg K (2006) Retrograde intussusception following Roux-en-Y gastric bypass. Obes Surg. 16:1101–1103
Kim YH, Blake MA, Harisinghani MG et al (2006) Adult intestinal intussusception: CT appearances and identification of a causative lead point. Radiographics. 26:733–744
Sundbom M, Karlson BM (2009) Low morality in bariatric surgery 1995 through 2005 in Sweden, in spite of shift of more complex procedures. Obes Surg. 19:1697–1701
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O’Connor, D.B., Ryan, R., O’Malley, D. et al. Retrograde Intussusception 5 years after Roux-en-Y gastric bypass for morbid obesity. Ir J Med Sci 181, 419–421 (2012). https://doi.org/10.1007/s11845-010-0577-0
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DOI: https://doi.org/10.1007/s11845-010-0577-0