Antiperistaltic Jejunal Intussusception into the Roux-en-Y Anastomotic Site after Distal Gastrectomy

Abstract

A 79-year-old man underwent distal gastrectomy and Roux-en-Y (R-Y) reconstruction for gastric cancer (pT4aN3M0 Stage IIIC). He presented with sudden-onset abdominal pain 22 months later. We suspected strangulation ileus and performed a laparotomy that showed that a 30-cm segment of the jejunum had retrogradely invaginated into the R-Y anastomotic site and had become necrotic. Manual reduction was difficult, and therefore, we resected the necrotic jejunum. Intussusception at the R-Y anastomotic site in adults following gastrectomy is extremely rare ; however, it must be considered as a differential diagnosis in postoperative intestinal obstruction with the objective of early diagnosis and intestinal salvage.