Intussusception of the jejuno-jejunal anastomosis in a patient with Roux-en-Y gastric bypass

Alain Palomares-Leal; Antonio Morales-Cardona; Julio Cesar Cortinas-González; Rogelio Alejandro Sifuentes-Gallardo; Carla Paulina Campos-Cruz; Samantha Jazmín De La Cruz-Hernández; Juan Pedro Silva-Martínez

doi:10.18203/2349-2902.isj20233343

Authors

Alain Palomares-Leal Department of General Surgery, Universidad de Monterrey, Christus Muguerza Hospital Alta Especialidad, Monterrey, Nuevo León, México
Antonio Morales-Cardona Department of General Surgery, Universidad de Monterrey, Christus Muguerza Hospital Alta Especialidad, Monterrey, Nuevo León, México
Julio Cesar Cortinas-González Department of General Surgery, Universidad de Monterrey, Christus Muguerza Hospital Alta Especialidad, Monterrey, Nuevo León, México
Rogelio Alejandro Sifuentes-Gallardo Department of General Surgery, Universidad de Monterrey, Christus Muguerza Hospital Alta Especialidad, Monterrey, Nuevo León, México
Carla Paulina Campos-Cruz Department of General Surgery, Universidad de Monterrey, Christus Muguerza Hospital Alta Especialidad, Monterrey, Nuevo León, México
Samantha Jazmín De La Cruz-Hernández Department of General Surgery, Centro Médico Nacional del Noreste, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México
Juan Pedro Silva-Martínez Department of General Surgery, Centro Médico Nacional del Noreste, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México

DOI:

https://doi.org/10.18203/2349-2902.isj20233343

Keywords:

Intussusception jejuno-jenunal anastomosis, Bariatric complications, Bariatric surgery, Acute abdominal pain

Abstract

Intussusception is a rare complication in postoperative patients undergoing Roux-en-Y gastric bypass (RYGB), with an incidence of 0.64%. The clinical presentation usually involves severe abdominal pain, accompanied by nausea and vomiting. The diagnostic approach using imaging studies involves computed tomography, revealing the radiological "target" sign. The treatment is surgical, with the lowest recurrence rate (12.5%) observed in the resection and anastomosis of the intussuscepted segment. The objective is to present the case of intussusception at the jejuno-jejunal anastomosis in a postoperative RYGB patient, along with its therapeutic approach, in a hospital in northern Mexico.

Metrics

Metrics Loading ...

References

Oor JE, Goense L, Wiezer MJ, Derksen WJM. Incidence and treatment of intussusception following Roux-en-Y gastric bypass: a systematic review and meta-analysis. Surg Obes Relat Dis. 2021;17(5):1017-28.

Orthopoulos G, Grant HM, Sharma P, Thompson E, Romanelli JR. S054: incidence and management of jejunojejunal intussusception after Roux-en-Y gastric bypass: a large case series. Surg Endosc. 2020;34(5):2204-10.

Brian TF, Jonathan FF. Abdominal pain after Roux-en-Y Gastric Bypass: A Review. JAMA Surg. 2023;2:8.

Buchwald H, Avidor Y, Braunwald E. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724-37.

Rondelli F, Bugiantella W, Desio M. Antecolic or retrocolic alimentary limb in laparoscopic Roux-en-Y gastric bypass? A meta-analysis. Obes Surg. 2016;26(1):182-95.

Escalona A, Devaud N, Pérez G. Antecolic versus retrocolic alimentary limb in laparoscopic Roux-en-Y gastric bypass: a comparative study. Surg Obes Relat Dis. 2007;3(4):423-7.

Kim Y, Crookes PF. Complications of bariatric surgery. In: Huang CK, ed. Essentials and Controversies in Bariatric Surgery. IntechOpen. 2014.

Schulman AR, Thompson CC. Abdominal pain in the Roux-en-Y gastric bypass patient. Am J Gastroenterol. 2018;113(2):161-6.

Schulman AR, Thompson CC. Complications of bariatric surgery: what you can expect to see in your GI practice. Am J Gastroenterol. 2017;112(11):1640-55.

Hwang RF, Swartz DE, Felix EL. Causes of small bowel obstruction after laparoscopic gastric bypass. Surg Endosc. 2004;18(11):1631-5.

Daellenbach L, Suter M. Jejunojejunal intussusception after Roux-en-Y gastric bypass: a review. Obes Surg. 2011;21(2):253-63.

Stephenson D, Moon RC, Teixeira AF, Jawad MA. Intussusception after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2014;10(4):666-70.

Varban O, Ardestani A, Azagury D. Resection or reduction? The dilemma of managing retrograde intussusception after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2013;9(5):725-30.

Diab AF, Oviedo RJ, Nazir S, Sujka JA, DuCoin CG. RYGB-induced gut dysmotility and retrograde intussusception: an unusual phenomenon. Obes Surg. 2022;32(10):3452-7.

Chahal-Kummen M, Blom-Høgestøl IK, Eribe I, Klungsøyr O, Kristinsson J, Mala T. Abdominal pain and symptoms before and after Roux-en-Y gastric bypass. BJS Open. 2019;3(3):317-26.