Open AccessRetrograde jejunogastric intussusception presenting as haematemesis in a patient following pancreaticoduodenectomy
Author(s) -
Tyson Moore,
Yahya AlHabbal,
Julian Choi
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-233851
Subject(s) - medicine , invagination , intussusception (medical disorder) , laparotomy , pancreaticoduodenectomy , anastomosis , whipple procedure , surgery , abdominal pain , mesentery , gastroenterostomy , jejunum , duodenum , general surgery , gastrectomy , resection , cancer
Intussusception is defined as the invagination of one part of the gastrointestinal tract into another. Jejunogastric intussusception is a rare phenomenon following major upper abdominal surgery, where its aetiology is not well understood. We describe a 68-year-old woman who presented with abdominal pain and haematemesis on the background of a previous pancreaticoduodenectomy (Whipple procedure) for pancreatic cancer. Gastroscopy demonstrated retrograde jejunogastric intussusception, where part of the efferent jejunal limb had prolapsed into the remnant stomach. As a consequence, this intussuscepted segment had become oedematous and ischaemic. The patient subsequently underwent a laparotomy, where the original gastrojejunostomy was resected, which showed the intussuscepted jejunum. The non-viable portion was removed and a Roux-en-Y anastomosis was created. This case highlights the need to 'think outside the box' with respect to differential diagnoses when a patient presents with abdominal pain on the background of previous complex abdominal surgery.