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Case Reports
. 2018 Aug 14;18(1):57.
doi: 10.1186/s12893-018-0392-5.

Duodenal intussusception of the remnant stomach after biliopancreatic diversion: a case report

J-N Kersebaum  1 , C Schafmayer  2 , M Ahrens  2 , M Laudes  3 , T Becker  2 , J H Beckmann  2
Affiliations
Case Reports

Duodenal intussusception of the remnant stomach after biliopancreatic diversion: a case report

J-N Kersebaum et al. BMC Surg. .

Abstract

Background: We present a rare case of an antegrade intussusception of the remnant stomach four years after a biliopancreatic diversion.

Case presentation: A 55-year-old female patient presented with epigastric pain in our emergency room. Laboratory parameters showed an anemia as well as elevated transaminases and hyperbilirubinemia. The CT scan showed an intussusception of the remnant stomach into the duodenum followed by cholestasis. At laparotomy the remnant stomach was resected.

Conclusion: Bowel obstruction and intussusception after bariatric surgery are a rare but often unrecognized complication. Sonography as well as a CT scan should be performed. The exploratory laparoscopy however is the most valuable diagnostic tool in patients with suspected intussusception, due to the high rate of non-specific symptoms and misinterpreted radiographic investigations.

Keywords: Intussusception; Morbid obesity; Scopinaro; Small bowel obstruction.

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Ethics approval and consent to participate

No ethics approval was needed.

Consent for publication

Written informed consent was obtained from the patient for publication of this article and any accompanying tables/images. A copy of this written consent is available for review by the Editor of this journal.

Competing interests

The authors declare that they have no competing interest.

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Figures

Fig. 1
Fig. 1
Vertical gastroplasty by Mason (left). Biliopancreatic Diversion by Scopinaro (middle). Resection of remnant stomach and redone gastrojejunal anastomosis (right)
Fig. 2
Fig. 2
a Coronal cross section CT with oral contrastation with a target sign. b Intraoperative image of the negative lumen of the intussuscepted remnant stomach. c Blunt manual reposition of the remnant stomach. d Fully repositioned remnant stomach (top) with the transverse colon (bottom) as a size comparison
See this image and copyright information in PMC

References

    1. Buchwald H, et al. Bariatric Surgery. JAMA. 2004;292(14):1724. doi: 10.1001/jama.292.14.1724. - DOI - PubMed
    1. Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database of Systematic Reviews. 2014;(8). Art. No.: CD003641. 10.1002/14651858.CD003641.pub4. - PMC - PubMed
    1. Koppman JS, Li C, Gandsas A. Small bowel obstruction after laparoscopic roux-En-Y gastric bypass: a review of 9,527 patients. J Am Coll Surg. 2008;206(3):571–584. doi: 10.1016/j.jamcollsurg.2007.10.008. - DOI - PubMed
    1. Daellenbach L, Suter M. Jejunojejunal intussusception after roux-en-Y gastric bypass: a review. Obes Surg. 2011;21(2):253–263. doi: 10.1007/s11695-010-0298-5. - DOI - PubMed
    1. Javanainen M, Penttilä A, Mustonen H, Juuti A, Scheinin T, Leivonen M. A retrospective 2-year follow-up of late complications treated surgically and endoscopically after laparoscopic roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) for morbid obesity. Obes Surg. 2018;28(4):1055-62. - PubMed

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