Jejunogastric intussusception after Whipple procedure with B-II reconstruction: a case report
Abstract Background Jejunogastric intussusception (JGI) is a rare but severe complication after gastric surgery. JGI can occur from a few days to 55 years postoperatively and has a reported incidence of < 0.1% in patients who undergo gastric surgery. We firstly report a male patient with duodenal...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-04-01
|
| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12876-020-01259-2 |
| _version_ | 1818518005312651264 |
|---|---|
| author | Yun-Xiao Lyu Yue-Ming Xu |
| author_facet | Yun-Xiao Lyu Yue-Ming Xu |
| author_sort | Yun-Xiao Lyu |
| collection | DOAJ |
| description | Abstract Background Jejunogastric intussusception (JGI) is a rare but severe complication after gastric surgery. JGI can occur from a few days to 55 years postoperatively and has a reported incidence of < 0.1% in patients who undergo gastric surgery. We firstly report a male patient with duodenal cancer who underwent Whipple’s procedure with side-to-side gastrojejunostomy and who subsequently developed JGI. A literature review is provided. Case presentation A 68-year-old man was admitted to our emergency department with left upper quadrant abdominal pain and hematemesis of 4 h’ duration. He had undergone Whipple’s procedure (duct-to-mucosa pancreaticojejunostomy and side-to-side gastrojejunostomy) with B-II reconstruction for duodenal papillary adenocarcinoma 5 years earlier. His vital signs were stable with a blood pressure of 163/93 mmHg, temperature of 37.0 °C; and heart and respiratory rates of 86 per/min and 20 per/min, respectively. Physical assessment showed mild tenderness in the left upper quadrant, only. A complete blood count showed white cell and platelet counts of 11.69 × 103/L and 196 × 103/L, respectively, and a hemoglobin level of 13.5 g/L. Abdominal computed tomography (CT) suggested a retrograde intussusception of the intestines into the stomach with dilatation of the remnant stomach. The patient immediately underwent exploratory laparotomy, which revealed a 20-cm retrograde efferent limb at the remnant stomach that had travelled through the previous gastrojejunostomy. There was no evidence of malignancy. We manually reduced the intussuscepted loop using gentle traction, and the viability of the intestinal loop was preserved. The patient had an uneventful postoperative recovery. Conclusion JGI is a rare but potentially fatal complication after gastric surgery, especially following Whipple’s procedure. Early diagnosis and treatment are crucial, and surgery is considered the most effective treatment for JGI. |
| first_indexed | 2024-12-11T01:04:09Z |
| format | Article |
| id | doaj.art-d69a9f51810f49348234caa5318187cb |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-11T01:04:09Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-d69a9f51810f49348234caa5318187cb2022-12-22T01:26:14ZengBMCBMC Gastroenterology1471-230X2020-04-012011410.1186/s12876-020-01259-2Jejunogastric intussusception after Whipple procedure with B-II reconstruction: a case reportYun-Xiao Lyu0Yue-Ming Xu1Department of Hepatobiliary Surgery, Dongyang People’s HospitalDepartment of Hepatobiliary Surgery, Dongyang People’s HospitalAbstract Background Jejunogastric intussusception (JGI) is a rare but severe complication after gastric surgery. JGI can occur from a few days to 55 years postoperatively and has a reported incidence of < 0.1% in patients who undergo gastric surgery. We firstly report a male patient with duodenal cancer who underwent Whipple’s procedure with side-to-side gastrojejunostomy and who subsequently developed JGI. A literature review is provided. Case presentation A 68-year-old man was admitted to our emergency department with left upper quadrant abdominal pain and hematemesis of 4 h’ duration. He had undergone Whipple’s procedure (duct-to-mucosa pancreaticojejunostomy and side-to-side gastrojejunostomy) with B-II reconstruction for duodenal papillary adenocarcinoma 5 years earlier. His vital signs were stable with a blood pressure of 163/93 mmHg, temperature of 37.0 °C; and heart and respiratory rates of 86 per/min and 20 per/min, respectively. Physical assessment showed mild tenderness in the left upper quadrant, only. A complete blood count showed white cell and platelet counts of 11.69 × 103/L and 196 × 103/L, respectively, and a hemoglobin level of 13.5 g/L. Abdominal computed tomography (CT) suggested a retrograde intussusception of the intestines into the stomach with dilatation of the remnant stomach. The patient immediately underwent exploratory laparotomy, which revealed a 20-cm retrograde efferent limb at the remnant stomach that had travelled through the previous gastrojejunostomy. There was no evidence of malignancy. We manually reduced the intussuscepted loop using gentle traction, and the viability of the intestinal loop was preserved. The patient had an uneventful postoperative recovery. Conclusion JGI is a rare but potentially fatal complication after gastric surgery, especially following Whipple’s procedure. Early diagnosis and treatment are crucial, and surgery is considered the most effective treatment for JGI.http://link.springer.com/article/10.1186/s12876-020-01259-2JejunogastricintussuceptionWhippleComplication |
| spellingShingle | Yun-Xiao Lyu Yue-Ming Xu Jejunogastric intussusception after Whipple procedure with B-II reconstruction: a case report BMC Gastroenterology Jejunogastricintussuception Whipple Complication |
| title | Jejunogastric intussusception after Whipple procedure with B-II reconstruction: a case report |
| title_full | Jejunogastric intussusception after Whipple procedure with B-II reconstruction: a case report |
| title_fullStr | Jejunogastric intussusception after Whipple procedure with B-II reconstruction: a case report |
| title_full_unstemmed | Jejunogastric intussusception after Whipple procedure with B-II reconstruction: a case report |
| title_short | Jejunogastric intussusception after Whipple procedure with B-II reconstruction: a case report |
| title_sort | jejunogastric intussusception after whipple procedure with b ii reconstruction a case report |
| topic | Jejunogastricintussuception Whipple Complication |
| url | http://link.springer.com/article/10.1186/s12876-020-01259-2 |
| work_keys_str_mv | AT yunxiaolyu jejunogastricintussusceptionafterwhippleprocedurewithbiireconstructionacasereport AT yuemingxu jejunogastricintussusceptionafterwhippleprocedurewithbiireconstructionacasereport |