Late Postoperative Anterograde Jejunojejunal Intussusception after Total Gastrectomy with Loop Esophagojejunostomy.
10.7704/kjhugr.2014.14.4.283
- Author:
Byung Moo AHN
1
;
Ju Seok KIM
;
Young Wook SONG
;
Dae Hyun TAK
;
Hee Seok MOON
;
Sun Hyung KANG
;
Jae Kyu SUNG
;
Hyun Yong JEONG
Author Information
1. Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea. mhs1357@cnuh.co.kr
- Publication Type:Case Report
- Keywords:
Anterograde;
Intussuscpetion;
Postoperative;
Complications;
Roux-en-Y esophagojejunostomy
- MeSH:
Edema;
Emergencies;
Endoscopy, Gastrointestinal;
Estrogens, Conjugated (USP);
Gastrectomy*;
Gastric Bypass;
Hemorrhage;
Humans;
Intussusception*;
Jejunum;
Middle Aged;
Postoperative Complications;
Postoperative Period
- From:The Korean Journal of Helicobacter and Upper Gastrointestinal Research
2014;14(4):283-287
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Anterograde jejunojejunal intussusception after total gastrectomy is a very rare postoperative complication. We report a 54-year-old man with a history of total gastrectomy, uncut Roux-en-Y gastric bypass, and Braun's jejunojejunal anastomosis. An upper gastrointestinal endoscopy revealed a bulky, reddish mass in the efferent loop with congestion, edema, and mucosal bleeding. An emergency computed tomography showed a target-like multilayered wall thickening in the afferent loop and a lamellar structure arranged in a concentric circle. Surgical exploration revealed an anterograde intussusception of the afferent proximal jejunum adjacent to the jejunojejunostomy site. This is a very uncommon occurrence because most intussusceptions after total gastrectomy are of the retrograde type. Moreover, anterograde jejunojejunal intussusception tends to occur in the early postoperative period. We report a case of late postoperative anterograde jejunojejunal intussusception after total gastrectomy with Braun's jejunojejunal anastomosis in a 54-year-old Korean man and review the related literature.