article = {AJSCR-2019-1-107}
title = {Common Jejunal Tract Intussusception into the Jejuno-Jejunal Anastomosis as Long-Term Complication after near Total Gastrectomy for Distal Gastric Cancer}
journal = {American Journal of Surgical Case Reports}
year = {2019}
issn = {2674-5046}
doi = {http://dx.doi.org/10.31487/j.AJSCR.2019.01.07}
url = {https://www.sciencerepository.org/common-jejunal-tract-intussusception-into-the-jejuno-jejunal-anastomosis_AJSCR-2019-1-107 
author = {Angelo Gragnaniello ,Ferdinando Amodio ,Francesco Corcione ,Mafalda Romano,Massimiliano Fabozzi,Pia Cirillo,Rosa Murano,}
keywords = {Near total gastrectomy, small bowel intussusception intestinal ischemia, bowel obstruction, gastric cancer}
abstract ={Background: Intussusception is a rare complication after Roux-en-Y gastric bypass (RYGB) and extremely
rare after near total gastrectomy.
Case Presentation: 46-years-old woman (BMI=40 kg/m2
, co-morbidity: hypertension) operated about
seven months before of near total gastrectomy (for distal gastric cancer) with a small bowel resection with
Roux and Y gastric reconstruction , presented epigastric pain after meals, alvus alterations lasting by a week,
vomiting in the last days with leukocytosis and transaminase and amylase increase. The CT scan showed
peri-hepatic fluid, gastric, duodenal and jejunal dilatation, a "target like imagine" of jejuno-jejunal
anastomosis with small bowel air-fluid levels, normal intestinal loop downstream the jejuno-jejunal
anastomosis. During laparoscopy we discovered ischemia of common jejunal tract intussuscepted into the
jejuno-jejunal anastomosis. The common ischemic intestinal tract and the anastomosis were resected “enbloc” and jejuno-jejunal anastomosis was performed again.
Conclusion: The symptoms of small bowel intussusception after near total gastrectomy are not specifics
but the risk of severe complications requires an early diagnosis and treatment. According to literature data,
CT-scan is the gold standard for the diagnosis but in unclear cases it is mandatory an early laparoscopic
exploration to confirm the clinical suspicion and to perform the appropriate treatment.}