Intestinal Intussusception in the Jejunum after Laparoscopic Distal Gastrectomy

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  • Sakai Ayano
    Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama
  • Hirano Katsuhisa
    Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama
  • Yamazaki Takeyoshi
    Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama
  • Kobiyama Ryosuke
    Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama
  • Nagamori Masakazu
    Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama
  • Shibuya Kazuto
    Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama
  • Yoshioka Isaku
    Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama
  • Matsui Koshi
    Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama
  • Okumura Tomoyuki
    Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama
  • Fujii Tsutomu
    Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama

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Other Title
  • 腹腔鏡下幽門側胃切除術Roux-en-Y再建術後に発生した胃空腸吻合部腸重積の1例

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Abstract

<p>A 79-year-old woman underwent laparoscopic distal gastrectomy and Roux-en-Y reconstruction for gastric cancer. Gastrojejunal anastomosis was performed with the overlap method. The patient suffered vomiting on postoperative day (POD) 3. Upper gastrointestinal endoscopy performed on POD 8 showed jejunal mucosa protruding into the remnant stomach, and the patient was diagnosed with intussusception in the gastrojejunal anastomosis. Endoscopic repositioning by pushing the edge of the jejunum was unsuccessful, and thus, surgical repositioning was performed on POD 22. Intraoperative findings confirmed that the stump of the ascending jejunal limb was invaginated into the remnant stomach. The jejunal intussusception could not be repositioned by the Hutchinson technique; therefore, the ascending jejunum was resected and a new gastrojejunal anastomosis was constructed. There are few reports of intestinal invagination at the anastomosis of the jejunum after distal gastrectomy. This case suggests that immediate reoperation should be considered when such an invagination is diagnosed.</p>

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