Coster David D, Sundberg Stephen M, Kermode David S, Beitzel Donald T, Noun Stefanie H, Severidt Matthew
Grinnell Bariatrics and Department of Surgery, Grinnell Regional Medical Center, Grinnell, Iowa, USA.
Surg Obes Relat Dis. 2008 Jan-Feb;4(1):69-72. doi: 10.1016/j.soard.2007.08.017. Epub 2007 Nov 5.
Intestinal obstruction due to intussusception, although rare, is a complication that can cause small bowel obstruction after Roux-en-Y gastric bypass. Possible causes include disordered intestinal motility, the presence of staple lines and other lead points in the intestinal wall, and the anatomic peculiarities of the enteroenterostomy. In the case of antegrade intussusception, the lead point is usually identifiable and can involve either limb. Retrograde intussusception is more common but usually has a featureless entry point beginning a few inches below the intestinal anastomosis, with the intussusceptum traversing the enteroenterostomy into either the biliary or Roux limb. Abdominal computed tomography scan is necessary for diagnosis, and early exploration is recommended to avoid ischemia and bowel resection.
肠套叠所致肠梗阻虽罕见，但却是Roux-en-Y胃旁路术后可导致小肠梗阻的一种并发症。可能的病因包括肠道动力紊乱、肠壁钉合线及其他潜在病因的存在，以及肠肠吻合术的解剖学特点。在顺行性肠套叠的情况下，潜在病因通常可明确，且可累及任何一段肠管。逆行性肠套叠更为常见，但通常在肠吻合口下方几英寸处起始点无特征，套入部穿过肠肠吻合口进入胆管或Roux肠袢。腹部计算机断层扫描对于诊断是必要的，建议早期探查以避免肠缺血和肠切除。
