Postoperative Intussusception

Abstract

We report a case of jejunogastric intussusception developed 15 years after gastrectomy, together with cumulated cases of postlaparotomy intussusception in adults and children from the domestic literature in which their differential pictures of the disease between both age groups are reviewed.A 59-year-old male visited our hospital complaining of upper abdominal pain and hematemesis, who had undergone gastrectomy with BII procedure for gastric ulcer 15 years before. As a result of UGI and GIF, it was diagnosed as intussusception of the efferent crus of jejunum into the residual stomach, laparotomy being performed. During surgery it was found that the efferent crus by about 30cm retrogressively prolapsed into the stomach to form a triple cyclindrical intussusception. A mild strangulation could be reduced by manipulation. Post-operative course was uneventful.In the past 4 decades, postlaparotomy intussusception has been reported in 266 adults and 53 children in this country. The manifestations can be predominantly seen after gastrectomy in the former, while after operation for retroperitoneal tumor in the latter. A difference lies in that the intussusceptions in children occurred in an extremely early period of around 5 days after surgery, most of which could be manually reduced, but those in adults developed in around 10 days after surgery, which commonly demanded excision of the intestine.