Intussusception After Two Decades of Gastrojejunostomy With Gastric Outlet Obstruction

Farhan Ahmed Majeed, Hassan Shabbir, Umar Bashir, Ahmad Raza, Nabeela Farhan, Adil Qayyum

Abstract

Intussusception occurring through a retrograde jejunogastric fashion  is one the rare causes of gastric outlet obstruction. Our case, a 55 year old patient, presented with epigastric pain, projectile vomiting and hematemesis following meals and fever. Ultrasound revealed intussusception at the splenic flexure while endoscopy showed a bosselated mass in the area of the body of the stomach with intact mucosa and visible peristalsis in mass. CT scan of the abdomen revealed a whirlpool sign in the area of the splenic flexture. Patient had abdominal surgery 20 year back however, procedure detail were unknown. Exploration revealed the gastrojejunostomy intussusception. Reduction and stitching of the small gut to the mesentery was done to avoid recurrence. Postoperative recovery was uneventful.

Key words

Retrograde intussusception, Gastric surgery, Gastrojejunostomy.