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Roux-en-Y retrograde intussusception: surgical reconstruction via sequential isoperistaltic side-to-side anastomoses
  1. Trevor C Chopko,
  2. Vineeth Sudhindran and
  3. Daniel Stephens
  1. Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Trevor C Chopko; chopko.trevor{at}mayo.edu

Abstract

Intussusception following Roux-en-Y gastric bypass is a rare, potentially life-threatening complication. Patients present with intermittent obstructive symptoms, and the diagnosis is made on imaging. Treatment is surgical considering the high likelihood of non-operative failure, strangulation, incarceration, perforation and concern for malignancy. We present the case of a woman in her 60s with a history of Roux-en-Y gastric bypass who presented with retrograde jejunojejunal intussusception at the distal Roux anastomosis. She proceeded to the operating room for complete anastomotic resection with reconstruction of three blind ends via two sequential isoperistaltic anastomoses. She progressed appropriately throughout her hospitalisation and was discharged on postoperative day 5 without recurrence. While intussusception in Roux-en-Y anatomy has been previously described, a literature review yielded sparse results in detailing its surgical correction. We highlight our unique surgical approach of jejunojejunal anastomotic resection with the creation of sequential isoperistaltic side-to-side anastomoses.

  • Small intestine
  • Adult intensive care
  • Gastrointestinal surgery
  • General surgery
  • Orthopaedic and trauma surgery

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: TCC, VS and DS. The following authors gave final approval of the manuscript: TCC, VS and DS.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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