A Case of Adult Intussusception in Whom Intussusception of the Intestinal Tract Developed Anal to the Y Anastomotic Site after Gastrectomy

Gonta Okumura, Hideaki Kaneko Toshiya Maeda, Ricca Fukuda, Yukari Yabuki, Atsusi Abiko Terufumi Yoshioka, Naoki Nibutani, Kyouzi Yamada and Mitsuhiko Iwasaki

2nd Depertment of Surgery St, Marianna University, School of Medicine

A 41-year-old man at the age of 25 years, underwent gastrectomy of the pylorus for gastric ulcer. The patient consulted our hospital for sudden-onset of intense abdominal pain, nausea and vomiting at night. During initial consultation, biochemical blood test revealed no abnormalities other than an increase in the leukocyte count. However, abdominal radiography disclosed an ilues. Furthermore, abdominal computed tomography (CT) demonstrated intussusception. Irritative peritoneal symptoms develped, and the patient was emergently admitted to our hospital, and surgery was immediately performed. During laparotomy, a moderate volume of bloody ascites was observed. Roux-en-Y reconstruction had been performed following gastrectomy of the pylorus. Intussusception of the jejunum, anal to the Y anastomotic site, was detected. The involved area measured approximatery 13 cm, and manual reduction was difficult, however partial resection of the small intestine was performed. No abnormal findings were found on the intestinal mucosa, such as polyp that might have formed the end of the intussusception. Adult intussusception at the Y anastomotic site following gastrectomy, as observed in the present case, is extremely rare. We report this patient with reference to the literature.

Key words
adult Intussusception, Roux-en-Y anastomosis

Reprint requests
Gonta Okumura 2nd Depertment of Surgery, St, Marianna University, School of Medicine 2-16-1 Sugao, Miyamae-ku Kawasaki, 216-8511 JAPAN

Accepted
March 31, 1999

To read the PDF file you will need Abobe Reader installed on your computer.