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Korean J Helicobacter  Up Gastrointest Res > Volume 14(4); 2014 > Article
The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2014;14(4):283-287.
DOI: https://doi.org/10.7704/kjhugr.2014.14.4.283    Published online December 10, 2014.
Late Postoperative Anterograde Jejunojejunal Intussusception after Total Gastrectomy with Loop Esophagojejunostomy
Byung Moo Ahn, Ju Seok Kim, Young Wook Song, Dae Hyun Tak, Hee Seok Moon, Sun Hyung Kang, Jae Kyu Sung, Hyun Yong Jeong
Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea. mhs1357@cnuh.co.kr
전위절제술 이후 후기 합병증으로 발생한 앞방향 장중첩증 1예
안병무, 김주석, 송영욱, 탁대현, 문희석, 강선형, 성재규, 정현용
충남대학교 의학전문대학원 내과학교실
Abstract
Anterograde jejunojejunal intussusception after total gastrectomy is a very rare postoperative complication. We report a 54-year-old man with a history of total gastrectomy, uncut Roux-en-Y gastric bypass, and Braun's jejunojejunal anastomosis. An upper gastrointestinal endoscopy revealed a bulky, reddish mass in the efferent loop with congestion, edema, and mucosal bleeding. An emergency computed tomography showed a target-like multilayered wall thickening in the afferent loop and a lamellar structure arranged in a concentric circle. Surgical exploration revealed an anterograde intussusception of the afferent proximal jejunum adjacent to the jejunojejunostomy site. This is a very uncommon occurrence because most intussusceptions after total gastrectomy are of the retrograde type. Moreover, anterograde jejunojejunal intussusception tends to occur in the early postoperative period. We report a case of late postoperative anterograde jejunojejunal intussusception after total gastrectomy with Braun's jejunojejunal anastomosis in a 54-year-old Korean man and review the related literature.
Key Words: Anterograde; Intussuscpetion; Postoperative; Complications; Roux-en-Y esophagojejunostomy
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