Korean J Helicobacter Up Gastrointest Res.  2014 Dec;14(4):283-287. 10.7704/kjhugr.2014.14.4.283.

Late Postoperative Anterograde Jejunojejunal Intussusception after Total Gastrectomy with Loop Esophagojejunostomy

• Ahn BM
• Kim JS
• Song YW
• Tak DH
• Moon HS
• Kang SH
• Sung JK
• Jeong HY

• KMID: 2305133
• DOI: http://doi.org/10.7704/kjhugr.2014.14.4.283

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.

Keyword

Anterograde; Intussuscpetion; Postoperative; Complications; Roux-en-Y esophagojejunostomy

MeSH Terms

Edema
Emergencies
Endoscopy, Gastrointestinal
Estrogens, Conjugated (USP)
Gastrectomy*
Gastric Bypass
Hemorrhage
Humans
Intussusception*
Jejunum
Middle Aged
Postoperative Complications
Postoperative Period
Estrogens, Conjugated (USP)