Abstract
A 76-year-old man, who had undergone a total gastrectomy 21 years prior, had a sudden onset of abdominal pain. Abdominal CT scan revealed a tumor with a layered structure in the upper abdomen. Jejunography revealed a crab-claw appearance. Intestinal obstruction caused by intussusceptions was diagnosed, and a laparotomy was performed. An invaginated bowel progressing in an antiperistaltic direction was present on the anal side of the Y-anastomosis. After manual replacement, a partial resection of jejunum was performed. No abnormalities were found at the resected jejunum. A year later, the patient again developed abdominal pain. CT scan revealed of an intussusception, and a laparotomy was performed. Retrograde invagination at the anal side of the Y-anastomosis was again found. The patient required a jejunum resection which included the Y-anastomosis. No subsequent relapses have been documented.
Intussusception after gastrectomy occurs rarely. Nevertheless, it must be kept in mind as a probable occurrence after gastrectomy.
