English

Abstract

Jejunogastricintussusception through a gastrojejunostomy stoma is one of the rarest complications of the previous gastric surgery. The incidence is reported to be less than 0.1%. An elderly male presented to the hospital with h/o vomiting, pain in abdomen since 10 days. The patient was undergone upper G I Scopy and CT scan abdomen as a suspected c/o carcinoma stomach. A primarily healed midline scar from the previous surgery for large duodenal perforation. On exploration it was found that there was a mass in the stomach, which on gastrotomy revealed gangrenous jejunal loops herniated through previous stoma. Gangrenous jejunum was resected and Billroth II was done. KEYWORDS: Jejunogastric, intussuception, gangrenous, gastrojejunostomy. INTRODUCTION: Jejunogastric intussusception (JGI) is a rare complication of gastrectomy with an incidence of 0.1%. It usually presents with severe epigastric pain, vomiting, and hematemesis. A history of gastric surgery can help in making an accurate and early diagnosis, which calls forth an urgent surgical intervention. Only reduction or resection with revision of the previously performed anastomosis is the choice which is decided according to the operative findings. We present a case of JGI in a patient with a history of operation for large duodenal perforation 6 yrs back. At emergent laparotomy, an efferent loop Jejunogastricintussuception was found. Due to necrosis, resection of the intussuscepted bowel with Roux-en-Y anastomosis was performed. Postoperative recovery was uneventful. A mortality rate of 10% and even as high as of 50% has been reported if surgical intervention has been delayed, (5, 6) therefore, early diagnosis of this condition is mandatory. Although a history of gastric surgery may help in making such a diagnosis, preoperative awareness of this condition has been reported to be difficult in most of the cases.