J Gastric Cancer.  2013 Dec;13(4):263-265.

Early Postoperative Retrograde Jejunojejunal Intussusception after Total Gastrectomy with Roux-en-Y Esophagojejunostomy: A Case Report

• Lee SY
• Lee JC
• Yang DH

Abstract

Intussusception is a rare cause of postoperative intestinal obstruction in adults. Many retrograde intussusceptions occur during the period following gastrectomy. A 77-year-old woman visited our hospital because of detected gastric adenocarcinoma. She received radical total gastrectomy with Roux-en-Y esophagojejunostomy. On the fifth postoperative day, she complained of abdominal pain, and we found leakage at the esophagojejunostomy site and dilatation of the Roux limb and the afferent limb of the jejunojejunostomy. Emergency surgery was performed. Retrograde jejunojejunal intussusception accompanied with a nasojejunal feeding tube was found at the efferent loop of the jejunojejunostomy. No ischemic change was found; therefore, manual reduction and primary repair of esophagojejunostomy was performed. She was discharged without complications on the 23rd re-postoperativeday. We suggest that the nasojejunal feeding tube acted as a trigger of intussusception because there was no definitive small bowel mass or postoperative adhesion. We present our findings here along with a brief review of the literature.

Keyword

Intussusception; Gastrectomy; Feeding tube

MeSH Terms

Abdominal Pain
Adenocarcinoma
Adult
Aged
Dilatation
Emergencies
Extremities
Female
Gastrectomy*
Humans
Intestinal Obstruction
Intussusception*

Figure

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  Fig. 1 Soluble contrast swallowing image. The contrast image shows leakage of contrast dye (black arrow), dilatation of the Roux limb (arrowhead), and afferent loop dilatation (white arrow).

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  Fig. 2 Intraoperative image. Retrograde jejunojejunal intussusception of the efferent loop of the jejunojejunostomy (arrow). The dilated jejunojejunostomy site (arrowhead). There was no ischemic change or necrosis of the bowel.

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