Anterograde jejunojejunal intussusception through the distal anastomosis as complication after Roux-en-Y gastric bypass

Acta Chir Belg. 2019 Dec;119(6):400-403. doi: 10.1080/00015458.2018.1479023. Epub 2018 Jun 7.

Abstract

Introduction: Small bowel intussusception is a rare complication after Roux-en-Y gastric bypass (RYGB) whose incidence tends to increase. This rising could be explained by an increasing bariatric surgery over the last two decades and by a better recognition of this potential complication. Patient and methods: We report a case of jejunojejunal intussusception in 33-year-old woman 2 years following a laparoscopic RYGB. She was taken to the operating room for exploratory laparotomy. Results: Its diagnosis is based on a combination of physical, radiological, and operative findings. The surgical exploration confirmed an anterograde jejunojejunal intussusception through the Roux-en-Y anastomosis. A lead point was not identified. We performed the resection of the blind extremity of the biliopancreatic limb to prevent recurrence. Conclusions: Small bowel intussusception is a rare long-term complication after RYGB. The underlying causative mechanism remains unclear. This rare condition may cause obstruction and lead to bowel necrosis if not recognized and treated promptly.

Keywords: Intussusception; Roux-en-Y gastric bypass; anterograde intussusception; bariatric; bowel obstruction.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anastomosis, Roux-en-Y / adverse effects*
  • Female
  • Gastric Bypass / adverse effects*
  • Humans
  • Intussusception / etiology
  • Intussusception / surgery*
  • Jejunal Diseases / etiology
  • Jejunal Diseases / surgery*
  • Laparoscopy
  • Obesity, Morbid / surgery*