RETROGRADE JEJUNAL INTUSSUSCEPTION AFTER TOTAL GASTRECTOMY-REPORT OF A CASE

Compared with intussusception in children as a common entity, the disease is relatively rare in adults and the rate of its occurrence after gastrectomy is said to amont to about 1% of all adult cases. This paper presents a case of retrograde jejunal intussusception 9 years after total gastrectomy in an adult. A 75-year-old man was seen at the hospital because of abrupt abdominal pain and vomiting. The abdomen was soft and no tumor was palpable. Abdominal x-ray film revealed a slight gas image in the small intestine. After admission, bloody discharge from a nasal tube was observed. Abdominal CT scan revealed a tumor with layered structure in the left upper abdomen. Intussusception was diagnosed and a laparotomy was performed. Macroscopically, the invaginated bowel progressing antiperistaltic direction over about 20cm was present at the anal side of Y-anastomosis after total gastrectomy (with Roux-Y reconstruction). After manual replacement, no ischemic changes nor organic disorders were confirmed in the invaginated jejunum and so the surgical incision was closed without any procedure. Although intussusception after gastrectomy rarely occurs, we must keep it in mind as a probable diagnosis after gastrectomy.