Ravirajendran S, Munnamgi S, Abdul A. Antegrade
jejunojejunal intussusception inside a retrograde jejunogastric intussusception (double intussusception)-A rare case report.
Int J Surg Case Rep 2017;
39:264-266. [PMID:
28881334 PMCID:
PMC5587876 DOI:
10.1016/j.ijscr.2017.08.036]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/18/2017] [Accepted: 08/18/2017] [Indexed: 11/30/2022] Open
Abstract
Acute retrograde jejunogastric intussusception is a rare event.
It presents as sudden onset epigastric pain with mass and vomiting in a patient who underwent previous gastric surgery.
The treatment of acute jejunogastric intussusception is prompt surgery.
Early surgical intervention prevents vascular compromise and bowel gangrene.
Introduction
Jejunogastric intussusception through a gastrojejunal stoma along with a jejunojejunal intussusception (intussusception within an intussusception) is a rare but serious complication of previous gastric surgery such as gastrojejunostomy and Billroth II gastrectomy. The incidence of which is less than 0.1%.
Case presentation
An elderly male presented with an abdominal lump, diffuse abdominal pain and vomiting for one-day duration. Ultrasound and CECT abdomen revealed dilated stomach with jejunojejunal intussusception herniating into stomach. Emergency laparotomy was done with manual reduction of intussusception loops and roux- en-y anastomosis.
Discussion
The number of cases reported in literature involving a jejunogastric intussusception following gastric surgery was about 300.Furthermore, there have been only two reported cases of jejunogastric intussusception along with jejunojejunal intussusception. The rarity of this clinical event makes it imperative for a high index of suspicion in patients presenting with abdominal pain following gastric surgery.
Conclusion
The mortality of this condition ranges from 10% to 50%. Hence prompt diagnosis and early surgical intervention prevents vascular compromise and bowel gangrene.
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