Hillenbrand Andreas, Waidner Uta, Henne-Bruns Doris, Maria Wolf Anna, Buttenschoen Klaus
Department of General, Visceral, and Transplantation Surgery, University Hospital of Ulm, Steinhoevelstr. 9, 89075, Ulm, Germany.
Obes Surg. 2009 May;19(5):664-6. doi: 10.1007/s11695-009-9819-5. Epub 2009 Mar 17.
A 42-year-old morbidly obese patient (BMI 44.1 kg/m(2)) was admitted to our emergency room with upper abdominal pain, nausea, and cholestasis. Nine years ago, a vertical banded gastroplasty had been performed (former BMI 53.5 kg/m(2)) with a subsequent weight loss to BMI 33.0 kg/m(2). After regaining weight up to a BMI of 47.6 kg/m(2), 5 years ago a conversion to a gastric bypass was realized. A computed tomography of the abdomen showed an invagination of the remaining stomach into the duodenum causing obstruction of the orifice of common bile duct. The patient underwent an open desinvagination of the intussusception and resection of the remaining stomach. Gastroduodenal intussusception is rare and mostly secondary to gastric lipoma. To prevent this rare but serious complication, the remaining stomach could be fixed at the crura of the diaphragm, tagged to the anterior abdominal wall by temporary gastrostomy tube, or resected.
一名42岁的病态肥胖患者（BMI 44.1 kg/m²）因上腹部疼痛、恶心和胆汁淤积入住我院急诊室。9年前，该患者接受了垂直束带胃成形术（既往BMI 53.5 kg/m²），随后体重减轻至BMI 33.0 kg/m²。体重恢复至BMI 47.6 kg/m²后，5年前又进行了胃旁路手术。腹部计算机断层扫描显示残余胃向十二指肠内套叠，导致胆总管开口梗阻。患者接受了肠套叠的开放复位及残余胃切除术。胃十二指肠套叠很少见，大多继发于胃脂肪瘤。为预防这种罕见但严重的并发症，可将残余胃固定于膈肌脚处，通过临时胃造瘘管固定于前腹壁，或进行切除。
