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KMID : 0931320140140040283
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대한상부위장관.헬리코박터학회지
2014 Volume.14 No. 4 p.283 ~ p.287
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Late Postoperative Anterograde Jejunojejunal Intussusception after Total Gastrectomywith Loop Esophagojejunostomy
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Ahn Byung-Moo
Kim Ju-Seok
Song Yuong-Wook
Tak Dae-Hyun
Moon Hee-Seok
Kang Sun-Hyung
Sung Jae-Kyu
Jeong Hyun-Yong
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Abstract
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Anterograde jejunojejunal intussusception after total gastrectomy is a very rare postoperative complication. We report a 54-year-oldman with a history of total gastrectomy, uncut Roux-en-Y gastric bypass, and Braun’s jejunojejunal anastomosis. An upper gastrointestinalendoscopy revealed a bulky, reddish mass in the efferent loop with congestion, edema, and mucosal bleeding. An emergencycomputed tomography showed a target-like multilayered wall thickening in the afferent loop and a lamellar structure arrangedin a concentric circle. Surgical exploration revealed an anterograde intussusception of the afferent proximal jejunum adjacent to thejejunojejunostomy site. This is a very uncommon occurrence because most intussusceptions after total gastrectomy are of the retrogradetype. Moreover, anterograde jejunojejunal intussusception tends to occur in the early postoperative period. We report a caseof late postoperative anterograde jejunojejunal intussusception after total gastrectomy with Braun’s jejunojejunal anastomosis ina 54-year-old Korean man and review the related literature.
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KEYWORD
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Anterograde, Intussuscpetion, Postoperative, Complications, Roux-en-Y esophagojejunostomy
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