A case of bowel intussusception in a 43-year-old woman with a history of Roux-en-Y gastric bypass surgery is presented. . . . Keywords Roux-en-Y gastric bypass Laparoscopic Morbid obesity Intussusception Small bowel intussusception after laparoscopic Roux-en-Y Clinical presentation is not specific. CT of the abdomen gastric bypass (LRYGB) is a rare but significant event with with contrast is the diagnostic test of choice, with an accuracy a reported incidence of about 0.1–0.3%. of 80%. Pathognomonic findings include a Btarget sign^ A 43-year-old woman with a retrograde intussusception (Fig. 1). Treatment remains controversial but an early identifi- 3 years after a LRYGB is presented. She had lost 50% of cation and surgical intervention seems to reduce morbidity and excess weight. She complained of paroxysmal, severe abdom- prevents recurrence. Laparoscopic approach is the treatment of inal pain as well as nausea and vomiting although, on exam- choice and most cases are resolved with simple reduction if the ination, no peritoneal signs were present. Laboratory data small bowel is viable, with or without enteropexy. were unremarkable. Abdominal contrast-enhanced computed The origin of intussusception after gastric bypass is differ- tomography (CT) showed a Btarget sign^ mass consistent with ent from that of intussusception
Journal of Gastrointestinal Surgery – Springer Journals
Published: May 29, 2018
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