Abstract
A patient, 55 years old male, had undergone Billroth II reconstruction for gastric cancer 20 years ago. He visited to our hospital because of frequent vomiting and epigas-tralgia. There were epigastric pain and tenderness, but abdominal mass and peritonism were not recognized. Gastroendoscopy was done on the following day. The mucosa of gastric remnant showed normal findings, but the jejunum invaginated into the stomach, and jejunal mucosa demonstrated redding, edematous, and ischemic change. Upper G-I series with gastrographin showed a large sausage shaped filling defect with coil-spring sign in the gastric remnant. Abdominal CT also revealed a spherical mass with coil-spring sign in the stomach. Based on the these findings emergency operation was done 38 hours after the onset of the symptom. On laparotomy, about 20 cm portion of the efferent loop from the retrocolic gastrojejunostomy had intussuscepted into the stomach. Reposition of the intussuscepted jejunal loop was difficult due to ischemia and end to end anastomosis of the jejunum was performed after resection of 20 cm intussuscepted intestine from the anas-tomotic site. Jejunogastric intussusception is a rare complication of gastrojejunal anastomosis. this time we have reported about its clinical caracteristics and literature reviews in japan.
