Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
BMJ Case Rep. 2024 Feb 17;17(2):e258660. doi: 10.1136/bcr-2023-258660.
Intussusception following Roux-en-Y gastric bypass is a rare, potentially life-threatening complication. Patients present with intermittent obstructive symptoms, and the diagnosis is made on imaging. Treatment is surgical considering the high likelihood of non-operative failure, strangulation, incarceration, perforation and concern for malignancy. We present the case of a woman in her 60s with a history of Roux-en-Y gastric bypass who presented with retrograde jejunojejunal intussusception at the distal Roux anastomosis. She proceeded to the operating room for complete anastomotic resection with reconstruction of three blind ends via two sequential isoperistaltic anastomoses. She progressed appropriately throughout her hospitalisation and was discharged on postoperative day 5 without recurrence. While intussusception in Roux-en-Y anatomy has been previously described, a literature review yielded sparse results in detailing its surgical correction. We highlight our unique surgical approach of jejunojejunal anastomotic resection with the creation of sequential isoperistaltic side-to-side anastomoses.
胃旁路术后肠套叠是一种罕见的、可能危及生命的并发症。患者表现为间歇性梗阻症状，诊断依赖于影像学检查。由于非手术治疗失败、绞窄、嵌顿、穿孔和恶性肿瘤的可能性较高，因此手术治疗是首选。我们报告了一位 60 多岁的女性病例，她曾接受过胃旁路手术，现因远端 Roux 吻合口处逆行空肠-空肠套叠而就诊。她被送往手术室进行完全吻合口切除，并通过两个连续的等蠕动吻合进行三个盲端重建。她在整个住院期间恢复良好，术后第 5 天出院，无复发。虽然 Roux-en-Y 解剖结构中的肠套叠此前已有描述，但文献回顾结果表明，详细描述其手术矫正的结果很少。我们强调了我们独特的手术方法，即空肠-空肠吻合口切除术，并创建了连续的等蠕动侧侧吻合。
