Department of Surgery, University of Minnesota Medical School, Minneapolis, MN 55455, USA.
Obes Surg. 2010 Aug;20(8):1191-4. doi: 10.1007/s11695-009-0037-y. Epub 2009 Dec 18.
Intussusception is a rare but worrisome cause of bowel obstruction in patients following Roux-en-Y gastric bypass. When intussusceptions is discovered in the general adult population, most often there is a "lead-point"; however, following bariatric procedures, this may not be true. There appears to be an increased incidence of this condition in open compared to laparoscopic Roux-en-Y gastric bypass procedures. Intussusception is often difficult to diagnose, especially in this population. Symptoms and signs can be very vague, and even computed tomography may not be accurate in diagnosing this condition. A high index of suspicion is required to successfully diagnose intussusception, and treatment often requires exploration and bowel resection. Herein, we report a case that follows several of these trends and suggests other possible contributions to intussusception. We also review other cases of intussusception after laparoscopic gastric bypass reported in the literature.
肠套叠是 Roux-en-Y 胃旁路术后患者肠梗阻的一种罕见但令人担忧的原因。当在普通成年人群中发现肠套叠时,大多数情况下存在“引导点”;然而,在减肥手术后,情况可能并非如此。与腹腔镜 Roux-en-Y 胃旁路手术相比,这种情况在开放式手术中似乎更为常见。肠套叠通常很难诊断,尤其是在这种人群中。症状和体征可能非常模糊,甚至计算机断层扫描也可能无法准确诊断这种情况。需要高度怀疑才能成功诊断肠套叠,治疗通常需要探查和肠切除。在此,我们报告了一例符合这些趋势的病例,并提出了肠套叠的其他可能原因。我们还回顾了文献中报道的腹腔镜胃旁路术后肠套叠的其他病例。