2023 Volume 65 Issue 4 Pages 344-352
A 78-year-old woman presented with vomiting and worsening abdominal pain in the right lower quadrant. Approximately 10 years earlier, she had undergone total gastrectomy with Roux-en-Y reconstruction for advanced gastric cancer. An abdominal contrast-enhanced CT scan detected a retrograde intussusception near the portion of Roux-en-Y anastomosis. Since there were few clinical findings suggestive of intestinal ischemia, we attempted an endoscopic reduction. However, on conducting the EGD, the intussusception was found to have spontaneously reduced. In the following days, the patient recovered from the abdominal pain and vomiting, and was subsequently discharged from the hospital.
Approximately one month later, she presented to our emergency room with the same symptoms as before. Physical exams and CT scan suggested that her symptoms were caused by a recurrence of the intussusception. Upon conducting an urgent EGD, the frontier of the intussusception was observed near the portion of the Y anastomosis. We successfully reduced the intussusception by passing the scope through the lumen of the frontier carefully and repeatedly, thus, avoiding an emergency surgery.
Jejunojejunal intussusception at the Y anastomosis site is a rare form of post-operative intussusception. To date, only a few cases of its successful management with the endoscopic approach have been reported.
