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. 2015 Dec;1(1):28.
doi: 10.1186/s40792-015-0028-2. Epub 2015 Mar 11.

Intussusception causing postoperative intestinal obstruction following free jejunum transfer in adults: two case reports and review of the literature

Akira Matsumoto  1 , Masayuki Watanabe  2 , Hironobu Shigaki  3 , Yasuhiro Okumura  4 , Koujiro Nishida  5 , Shinji Mine  6 , Kazuhiko Yamada  7 , Katsuhiko Yanaga  8 , Takeshi Sano  9
Affiliations

Intussusception causing postoperative intestinal obstruction following free jejunum transfer in adults: two case reports and review of the literature

Akira Matsumoto et al. Surg Case Rep. 2015 Dec.

Abstract

Intussusception is a rare cause of postoperative intestinal obstruction in adults. We experienced two cases of bowel obstruction due to the jejuno-jejunal intussusception after harvest of a free jejunum graft for reconstruction after cervical esophagectomy. Bowel obstruction occurred early in the postoperative course, and reoperations were needed in both cases. In both case, the anastomotic site was resected and re-anastomosed in a side-to-side fashion. Recurrence of intussusception has not been observed. In the literature, such a complication has been documented in two case series and a case report. The reported incidence of postoperative intussusception of the case series was 2.8% and 7.4%, respectively. The jejuno-jejunal anastomoses were performed with end-to-end fashion by two layered hand-sewn suture (Albert-Lembert method) in all cases reported. In order to prevent the occurrence of postoperative intussusception, we recommend to harvest a free jejunal graft as far from the Treitz ligament as possible and to avoid reconstruction by an Albert-Lembert end-to-end anastomosis.

Keywords: Bowel obstruction; Complication; Free jejunum transfer; Intussusception.

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Figures

Figure 1
Figure 1
Abdominal computed tomography. A multiplex ring-formed mass connected with the small intestine.
Figure 2
Figure 2
Intraoperative finding. Intussusception was caused by intestinal anastomosis.
See this image and copyright information in PMC

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