Yoshiyama Shigeyuki, Toiyama Yuji, Ichikawa Takashi, Shimura Tadanobu, Yasuda Hiromi, Hiro Jun-Ichiro, Ohi Masaki, Araki Toshimitsu, Kusunoki Masato
Department of Gastrointestinal, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan.
Department of Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan.
Asian J Endosc Surg. 2019 Apr;12(2):171-174. doi: 10.1111/ases.12611. Epub 2018 Jun 5.
The cause of jejunojejunal intussusception, a rare complication after Roux-en-Y gastric surgery, remains unclear. Here, we present a case of retrograde jejunojejunal intussusception that occurred after laparoscopic distal gastrectomy with Roux-en-Y reconstruction. A 51-year-old woman who had undergone laparoscopic distal gastrectomy and Roux-en-Y reconstruction for early gastric cancer 6 years previously was admitted to our hospital with abdominal pain. Abdominal CT revealed the "target sign," and she was diagnosed as having small bowel intussusception. Laparoscopic surgery resulted in a diagnosis of retrograde intussusception of the distal jejunum of the Roux-en-Y anastomosis with retrograde peristalsis in the same area. The Roux-en-Y anastomosis site and intussuscepted segment were resected laparoscopically. To the best of our knowledge, this is the first report of laparoscopic diagnosis of retrograde peristalsis in the distal jejunum of a Roux-en-Y anastomosis. Additionally, relevant published reports concerning this unusual condition are discussed.
空肠空肠套叠是Roux-en-Y胃手术后一种罕见的并发症,其病因尚不清楚。在此,我们报告一例腹腔镜远端胃切除并Roux-en-Y重建术后发生的逆行性空肠空肠套叠病例。一名51岁女性,6年前因早期胃癌接受了腹腔镜远端胃切除及Roux-en-Y重建手术,因腹痛入住我院。腹部CT显示“靶征”,她被诊断为小肠套叠。腹腔镜手术诊断为Roux-en-Y吻合口远端空肠逆行套叠,且同一区域存在逆行蠕动。通过腹腔镜切除了Roux-en-Y吻合部位和套叠肠段。据我们所知,这是首例腹腔镜诊断Roux-en-Y吻合口远端空肠逆行蠕动的报告。此外,还讨论了有关这种罕见情况的相关已发表报告。