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Roux-en-Y胃旁路术后妊娠并发逆行性肠套叠:一例报告

Retrograde intussusception in pregnancy following Roux-en-Y gastric bypass: a case report.

作者信息

Abd-El-Hafez Mahmoud K, Beyer Todd D, Applewhite Megan K

机构信息

Albany Medical College, School of Allopathic Medicine, 43 New Scotland Ave, Albany, NY 12208, United States.

Albany Medical Center, Department of Endocrine Surgery, Albany Med Health System, 43 New Scotland Ave, Albany, NY 12208, United States.

出版信息

J Surg Case Rep. 2025 Aug 21;2025(8):rjaf637. doi: 10.1093/jscr/rjaf637. eCollection 2025 Aug.

Abstract

Intussusception is the invagination of the bowel onto itself. Because of the unary nature of peristalsis, most cases of intussusception are anterograde, making retrograde intussusception exceedingly rare. We herein present a 23-year-old female in her 36 week gestation with a 24-hour history of diffuse abdominal pain, nausea, and hematemesis, 3 years following a Roux-en-Y gastric bypass. Abdominal computed tomography with subsequent exploratory laparotomy confirmed the diagnosis of retrograde intussusception at the jejunojejunostomy anastomosis. The jejunojejunostomy along with the proximal jejunal common channel was resected, and a new jejunojejunostomy anastomosis was reconstructed. Patient was discharged on postoperative day (POD) 9 with systemic anticoagulation for superior mesenteric vein thrombosis. There are very few documented cases in the literature of retrograde intussusception following gastric bypass procedures in pregnant women.

摘要

肠套叠是一段肠管套入自身。由于蠕动的单向性,大多数肠套叠病例是顺行性的,逆行性肠套叠极为罕见。我们在此报告一名23岁孕36周的女性,在接受Roux-en-Y胃旁路手术3年后,出现弥漫性腹痛、恶心和呕血24小时。腹部计算机断层扫描及随后的剖腹探查术证实空肠空肠吻合口处发生逆行性肠套叠。切除空肠空肠吻合口及近端空肠共同通道,并重建新的空肠空肠吻合口。患者于术后第9天出院,因肠系膜上静脉血栓形成接受全身抗凝治疗。文献中记录的孕妇胃旁路手术后发生逆行性肠套叠的病例非常少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94ed/12370245/145cbae9c7f5/rjaf637f1.jpg

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