Khanna Seema, Kumar Dinesh, Khanna Rahul, Gupta Sanjeev Kumar
Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005 India.
Indian J Surg. 2014 Apr;76(2):152-3. doi: 10.1007/s12262-012-0552-2. Epub 2012 Jul 4.
Jejunojejunal intussusception with internal herniation of the stomach through a gastrojejunostomy stoma is one of the rarest complications of the previous gastric surgery. The incidence is reported to be less than 0.1 %. An elderly male presented to the emergency room with signs of intestinal obstruction for 1 day. There was also history of appearance of a lump in the mid-abdomen. A primarily healed midline scar of the previous surgery was present; the details of which were not known. X ray abdomen in the erect posture showed multiple air fluid levels. Ultrasonography (USG) revealed dilated stomach with central hyperechogenicity with a peripheral rim of decreased echogenecity. Contrast-enhanced computed tomography (CECT) scan showed jejunojejunal intussusception with internal herniation of the stomach. On laparotomy, it was found that there was a previous gastrojejunostomy with jejunal invagination leading to gangrene of a segment. Resection anastomosis was done. The postoperative period was uneventful.
胃空肠吻合口处胃内疝形成伴空肠-空肠套叠是既往胃手术最罕见的并发症之一。据报道，其发生率低于0.1%。一名老年男性因肠梗阻症状1天就诊于急诊室。患者还有中腹部出现肿块的病史。可见既往手术的中线瘢痕已一期愈合，具体手术细节不详。立位腹部X线片显示多个气液平面。超声检查（USG）显示胃扩张，中央回声增强，周边回声减弱。增强计算机断层扫描（CECT）显示空肠-空肠套叠伴胃内疝形成。剖腹探查发现既往行胃空肠吻合术，空肠套叠导致一段肠管坏疽。行肠切除吻合术。术后恢复顺利。
