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Case report
Retrograde jejunogastric intussusception presenting as haematemesis in a patient following pancreaticoduodenectomy
  1. Tyson A Moore,
  2. Yahya Al-Habbal and
  3. Julian M Choi
  1. Department of Surgery, Western Health, Footscray, Victoria, Australia
  1. Correspondence to Yahya Al-Habbal; yahya{at}alhabbal.info

Abstract

Intussusception is defined as the invagination of one part of the gastrointestinal tract into another. Jejunogastric intussusception is a rare phenomenon following major upper abdominal surgery, where its aetiology is not well understood. We describe a 68-year-old woman who presented with abdominal pain and haematemesis on the background of a previous pancreaticoduodenectomy (Whipple procedure) for pancreatic cancer. Gastroscopy demonstrated retrograde jejunogastric intussusception, where part of the efferent jejunal limb had prolapsed into the remnant stomach. As a consequence, this intussuscepted segment had become oedematous and ischaemic. The patient subsequently underwent a laparotomy, where the original gastrojejunostomy was resected, which showed the intussuscepted jejunum. The non-viable portion was removed and a Roux-en-Y anastomosis was created. This case highlights the need to ‘think outside the box’ with respect to differential diagnoses when a patient presents with abdominal pain on the background of previous complex abdominal surgery.

  • surgery
  • general surgery
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Footnotes

  • Contributors Below are the names of all of the authors for this case report, detailing their specific contributions in the production of this manuscript. TAM: this author was responsible for compiling patient information and images, organising patient consent, writing the manuscript and editing the manuscript. YAH: this author was responsible for providing analytical input on the case report findings, and editing the manuscript. JMC: this author was responsible for overall supervision of the case report, conception of the case report, obtaining intraoperative photographs and editing the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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