Retrograde Jejunogastric Intussusception Research Articles

Jejunogastric intussusception associated with jejunojejunal intussusception (double telescoping) occurring 20 years after gastrojejunostomy.

Jejunogastric intussusception (JGI) is a rare but potentially lethal complication following gastrectomy or gastrojejunostomy surgeries. Diagnosis of this condition can be challenging due to its rarity and non-specific symptoms. This article presents a case report of a 60-year-old male with a history of trans mesocolic gastrojejunostomy who developed acute symptoms of JGI. The patient presented with acute epigastric pain, vomiting, and hematemesis. Physical examination and laboratory tests indicated dehydration, tachycardia, and leukocytosis. Computed tomography (CT) revealed intussuscepted loops within the stomach. Emergency laparotomy was performed, and the intussusception was manually reduced without the need for resection. The patient recovered well and was discharged five days post-surgery. Retrograde jejunogastric intussusception is a rare complication, often occurring years after gastric surgery. It can be classified into acute and chronic forms, with the former presenting with intense pain and potential hematemesis. The condition can arise in different surgical contexts and even spontaneously. The cause of JGI remains unclear, but factors such as hyperacidity, abnormal motility, and increased intra-abdominal pressure have been implicated. Diagnosis can be made through endoscopy or alternative imaging modalities such as CT. Surgical intervention is the treatment of choice, with various options available based on intraoperative findings. Retrograde jejunogastric intussusception is challenging to diagnose and treat due to its rarity and lack of understanding of its causes. Imaging techniques and endoscopy play important roles in diagnosis, while surgery remains the primary treatment option. Vigilance is necessary among medical professionals to consider JGI in cases of acute abdominal pain and vomiting following gastric surgery, allowing for prompt diagnosis and intervention to prevent bowel necrosis. Further research is needed to establish optimal surgical strategies and evaluate recurrence rates.

A rare case of internal herniation with retrograde jejunogastric intussusception into the stomach

AbstractJejunogastric intussusception (JGI) is a rare long‐term complication of Billroth II gastrectomy. It presents potentially lethal complication of gastrectomy or gastrojejunostomy which can occur any time after a gastric operation. Delayed diagnosis can lead to high morbidity and even mortality. Prompt surgical intervention is mandatory after early diagnosis. Endoscopy and abdominal computed tomography (CT) scanning are the main diagnostic tools. For gastric surgery patients who later experience sudden onsets of epigastric pain, vomiting, or subsequent hematemesis, JGI should be considered. A 77‐year‐old man who had a Billroth II gastrectomy 30 years prior to admission presented to our emergency department due to multiple episodes of epigastric colicky pain and hematemesis. He underwent esophagogastroduodenoscope and an abdominal CT scan. We provided a systemic image description of a rare case of internal herniation with retrograde JGI into the stomach. The patient received emergent laparotomy and resection of the efferent loop of the jejunum with the gangrenous segment. He was discharged 10 days after admission. JGI is a rare but potentially fatal disease. Early diagnosis and surgical treatment are important to avoid subsequent high mortality.

A retrograde intussusception of Roux-en-Y gastrojejunostomy: an unusual cause of haematemesis

Jejunogastric intussusception is a rare complication following gastric surgery and is estimated to occur in less than 0.1% of patients. It is a potentially fatal complication, if prompt diagnosis and surgical intervention is not performed immediately. Here, we present a case of retrograde jejunogastric intussusception who presented with haematemesis. Patient was diagnosed by an upper GI endoscopy. The diagnosis, management and the etiological theories of jejunogastric intussusception following gastric surgery are discussed here .

Retrograde Jejunogastric Intussusception (RJGI): A Life- Threatening Complication after Gastric Bypass Surgery

Retrograde jejunogastric intussusception (RJGI) after gastric bypass surgery is a rare but potentially life threatening complication. This complication may develop after simple gastrojejunostomy, after lower partial resection of stomach with gastrojejunostomy (Billroth-II gastric surgery) or after Roux-en-Y gastric bypass. Among the three anatomic type of jejunogastric intussusception (JGI), type-II is the commonest variety. The acute form is a surgical emergency. Mortality rate is very high. Little is known about the mechanism but many literatures indicate abnormal motility may be a cause. A 50 year old male presented to us with a three month history of repeated vomiting and one day of upper mid-abdominal pain. He had a history of gastric bypass for pyloric stenosis 12 years back. Diagnosis was confirmed by upper GI endoscopy. At laparotomy type II retrograde jejunogastric intussusception was identified. En-block resection of affected segment of jejunum and lower part of the stomach was done followed by Roux-en-Y reconstruction. RJGI is a rare complication of gastric bypass surgery. Early diagnosis is imperative. High index of suspicion is therefore important. Barium meal X-ray, ultra sonogram, enhanced CT scan occasionally be diagnostic, but endoscopy is certainly diagnostic in experienced hand. Laparotomy is mandatory. Surgical options include simple reduction, en-block resection and/or plication.J Bangladesh Coll Phys Surg 2015; 33(3): 161-165

Retrograde jejunogastric intussusception; varied clinical and endoscopic presentation: A cases series

AbstractRetrograde jejunogastric intussusception is a rare complication of gastric surgery. Approximately 250 cases have been reported till now. It has varied clinical and endoscopic presentations. Since gastrojejunostomy with vagotomy are on a declining trend, it is extremely rare to come across such a complication. The condition can be acute and life threatening or chronic and disabling. We report four such cases with different endoscopic and clinical presentations.

Retrograde jejunogastric intussusception: a single-institution experience over two decades

Background:  Jejunogastric Intussusception (JGI) after gastrojejunostomy is a rare and serious complication. Methods: Retrospective analysis of patients with a diagnosis of JGI was analyzed from November 1995 to October 2015 at our institute. Patient data regarding clinical presentation, investigations, surgical procedures, outcomes and follow-up were obtained from medical records. Results:  There were 13 cases of JGI. All were males. The mean age at presentation was 54.69 years (range 46-62). All patients presented with hematemesis or coffee ground vomiting. The time duration from gastrojejunostomy was 5 to 25 years. Upper gastrointestinal endoscopy was diagnostic in 10 cases. In 3 patients, 2 were misdiagnosed as bleeding tumour and as polyp in one patient during endoscopy. All patients underwent surgical management. Most commonest type was Type II (efferent loop) seen in 10 patients; Type III (combined type) was seen in 2 patients. One patient had Type I (afferent loop). Two patients had postoperative wound infection. On median follow-up of 6 years, there were no recurrences. Conclusions:  JGI is a rare complication after gastrojejunostomy. Upper gastrointestinal endoscopy is the most accurate diagnostic technique when performed by an experienced endoscopist. Emergency surgery still remains the main stay of treatment. A high index of suspicion is required for diagnosis in patients with prior history of gastrojejunostomy.

English

INTRODUCTION: Jejunogastric intussusception is a rare but potentially very serious complication of gastrectomy or gastroenterostomy described in 1941 by Bozzi.1 Only about 200 cases have been reported in literature to date. Diagnosis of this condition is difficult in most of the cases. To avoid mortality early diagnosis and prompt surgical intervention is mandatory. Since gastrojejunostomy with vagotomy are on a declining trend, it is extremely rare to come across such a complication.2 This paper reports a case of retrograde jejunogastric intussusception in a patient who underwent gastrojejunostomy 20 years back for bleeding peptic ulcer.

Retrograde jejunogastric intussusception: A case report and review of the literature

Retrograde jejunogastric intussusception (JGI) is a rare but potentially fatal complication after previous gastrectomy or gastric bypass surgery. Because of the prevalence of bariatric surgery, the number of cases of postoperative intussusception has increased markedly. Here, we present the case of a patient with retrograde jejunogastric intussusception, having a previous history of subtotal gastrectomy and gastrojejunostomy for peptic ulcer disease. Correct preoperative diagnosis was made by plain abdominal film, upper gastrointestinal series, computed tomographic scan, and esophagogastroduodenoscopy. The diagnosis was confirmed by laparoscopic examination.

Retrograde jejuno-gastric intussusception following Billroth II gastrectomy with Braun's jejuno-jejunostomy

Retrograde jejuno-gastric intussusception is a potentially fatal complication of a Billroth II gastrectomy [1, 2]. In all, there are just over 200 cases reported [2]. The condition may present with varied clinical presentations like abdominal pain, vomiting, haematemesis, gastric outlet obstruction, intestinal obstruction, and intestinal gangrene [1,3-6]. To the best of our knowledge, there are no reported cases of haematemesis presenting in a patient with retrograde jejuno- gastric intussusception through a Braun's jejuno-jejunostomy. We present a case that highlights an unusual type of retrograde gangrenous intussusception which occurred across two points of previous anastomosis i.e. jejuno-jejunostomy and gastro-jejunostomy simultaneously. Sri Lanka Journal of Surgery 2013; 31(3):64-65 DOI: http://dx.doi.org/10.4038/sljs.v31i3.5191

Retrograde jejunogastric intussusception: A case report and review of literature

Retrograde jejunogastric intussusception ( JGI) is a rare but potentially serious complication of gastrectomy or gastrojejunostomy. Only about 200 cases have been reported in the literature. We present a case of retrograde JGI in a 50-year-old female patient with a history of gastrojejunostomy who had increasing abdominal pain and vomiting for 1 week and hematemesis for 1 day. Emergency endoscopy revealed JGI that was confirmed at laparotomy. The gangrenous efferent limb was resected and a partial gastrectomy with Roux-en-Y-gastrojejunostomy was performed. We present this case for its rarity and the diagnosis of retrograde JGI should be kept in mind when the patients have history of gastric surgery. In our case, the patient was treated as recurrent peptic ulcer and she was referred to us only after she had hematemesis. To avoid mortality, early diagnosis and prompt surgical intervention is mandatory.

Retrograde jejunogastric intussusception following Braun’s jejunojejunostomy

Jejunogastric intussusception is a rare long term complication of Billroth II gastrectomy. The case reported here is a 50 year old man with history of a Billroth II gastrectomy and Braun's side-to-side jejunojejunal anastomosis who presented with hematemesis. On abdominal examination, there was a mass in the left iliac fossa. Computed tomography scan showed a retrograde jejunogastric intussusception across the gastrojejunostomy. On laparotomy, a retrograde intussusception of the distal jejunum through the jejunojejunal anastomosis and across the gastrojejunostomy with a gangrenous intussusceptum was found. The jejunojejunal anastomosis was taken down, the gangrenous segment was resected and bowel continuity was restored with two jejunojejunal anastomoses, proximal and distal to the gastrojejunostomy. The gastrojejunostomy was preserved. This case brings out an unusual type of retrograde gangrenous intussusception which occurred at two points of a previous anastomosis, i.e., jejunojejunostomy and gastrojejunostomy simultaneously, which could be managed with jejunal resection.

Retrograde jejunogastric intussusception: A rare case report and review of literature

Retrograde jejunogastric intussusception (JGI) is an unusual complication following gastrojejunostomy and Billroth II gastrectomy. It was first described in 1914 by Bozzi in a patient with gastrojejunostomy, and about 300 cases have been reported so far in the medical literature. High index clinical suspicion is required to make the diagnosis. Pyloroplasty is one of the well-accepted and proven surgical options in such cases. We report a case of retrograde JGI involving both loops of jejunum in a male patient who underwent truncal vagotomy and posterior gastrojejunostomy for chronic duodenal ulcer 6 years ago.

Imaging Depiction of Retrograde Jejunogastric Intussusception

Retrograde jejunogastric intussusception is an unusual long term complication of gastro-jejunostomy or Billroth-II reconstruction. Acute and chronic forms have been well recognised with the acute form being fatal without timely surgical intervention. The imaging findings are diagnostic, and an established emergency imaging protocol would be very useful for clinical decision making, as the clinical features are usually ambiguous. We present the systematic imaging description in a case of retrograde (type II) jejunogastric intussusception with strangulation following gastric bypass procedure.

A rare cause of coffee-ground vomiting: Retrograde jejunogastric intussusception

Retrograde jejunogastric intussusception is a well-recognised, rare, but potentially fatal long-term complication of gastrojejunostomy or Billroth II reconstruction. Only about 200 cases have been reported in the literature to date. Diagnosis of this condition is difficult in most cases. To avoid mortality, earlydiagnosis and prompt surgical intervention is mandatory. Since gastrojejunostomies with vagotomy are on a declining trend, it is extremely rare to come across such a complication. We report on such a patient who presented with haematemesis.

Retrograde jejunogastric intussusceptions: A rare case report

Retrograde jejunogastric intussusception is a rare acute abdominal condition where the small bowel loops get incarcerated and may get strangulated inside the stomach. We report one such rare case of a 50-year-old female who had retrograde jejunogastric intussusception following gastrojejunostomy and outline our treatment. Retrograde jejunogastric intussusception is a rare acute abdominal condition which is a rare complication after gastric surgery. The presence of a mobile mass associated with nausea and vomiting in a patient with previous history of gastric surgery is virtually pathognomic of acute retrograde intussusception. A high degree of suspicion is required for pre-operative diagnosis of the case which should be followed by prompt surgery.

Retrograde Jejunogastric Intussusception: A Case Report

Jejunogastric Intussusceptions is a rare but potentially life threatening complication of a previous gastrectomy or gastrojejunostomy. A 70 years old man presented with severe epigastric pain followed by haematemesis, 8 years after truncal vagotomy and gastrojejunostomy for pyloric stenosis. Ultrasonography revealed dilated stomach with a large intragastric mass which has minimal peristaltic movement. Endoscopy of upper GIT revealed prolapsed segment of jejunal loops through the gastrojejunostomy stoma. Laparotomy disclosed a retrograde type II jejunogastric intussusception and was managed by reduction of jejunogastric intussusception, resection of gangrenous segment and end to end anastomosis. Post operative recovery was uneventful. Retrograde jejunogastric intussusceptions is a rare condition and around 200 cases has been reported since its first description in 1914. Urgent recognition and surgical treatment is mandatory to reduce the mortality rate from this complication. Key words: Retrograde Jejunogastric Intussusception; gastrojejunostomy; gastric surgery. DOI: 10.3329/fmcj.v5i1.6812Faridpur Med. Coll. J. 2010;5(1):32-34

Anterograde jejunojejunal intussusception resulted in acute efferent loop syndrome after subtotal gastrectomy

Postoperative intussusception is an unusual clinical entity in adults, and is rarely encountered as a complication following gastric surgery. The most common type after gastric surgery is retrograde jejunogastric intussusception, and jejunojejunal intussusception has been rarely reported. We report a case of anterograde jejunojejunal intussusception after radical subtotal gastrectomy with Billroth II anastomosis in a 38-year-old Korean woman with early gastric cancer, and include a review of the literature on this unusual complication.

Retrograde Jejunogastric l ntussusception (RJGI): Two Case Reports

Retrograde  jejunogastric   intussusception (RJGI)   is   a   rare   but    potentially   very   serious complication of gastrojejunostomy or partial gastrectomy. Around 200 cases have been reported in literature till now. This paper reports two cases of RJGI of efferent loops developed 20 years and 10 years after gastrojejunostomy of a 70 years and 78 years old man respectively. Both the patients presented with sudden ab dominal  pain and hematemesis. Upper GI-endoscopy established the diagnosis. On emergency basis laparotomy was done and intussusception was reduced through gastrotomy. Efferent loop was found viable in case no 01, but gangrenous in case no 02, where resection was done. In both the cases the efferent loops were fixed to anterior parietal wall to prevent recurrence. Postoperative recovery were uneventful except minor superficial wound infection in the second case.TAJ 2009; 22(1): 257-260

Retrograde jejunogastric intussusception with strangulation after posterior gastrojejunostomy

Jejunogastric intussusception is a rare complication of gastrojejunostomy or partial gastrectomy [1, 2]. Bozzi described the first case of this complication in 1914. Around 200 cases have been reported in the literature till now. This paper reports a case of retrograde jejunogastric intussusception of efferent loop with strangulation developing in a 60 year old male patient who underwent surgery for acid peptic disease 15 years back, the details of which were not known.

Retrograde jejunogastric intussusception caused by a migrated gastrostomy tube

Retrograde jejunogastric intussusception caused by a migrated gastrostomy tube