S054: incidence and management of jejunojejunal intussusception after Roux-en-Y gastric bypass: a large case series

Orthopoulos, Georgios; Grant, Heather M.; Sharma, Parth; Thompson, Erin; Romanelli, John

doi:10.1007/s00464-019-07009-0

Cited by 24 publications

(32 citation statements)

References 13 publications

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“…Most of the reports of the disease are jejunum-jejunum intussusception after obese patients underwent gastrectomy and gastrojejunostomy. The reason may be that the separation of the jejunum and duodenal pacemaker cells after surgery leads to abnormal peristaltic waves, the mesentery becomes thinner after weight loss and the jejunum-jejunum anastomosis is related [ 6 ]. It can also occur when a gastric catheter is placed after gastrostomy and when duodenal jejunostomy is performed for duodenal atresia [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

The diagnosis and treatment of retrograde intussusception: a single-centre experience

Zhang

Liu

et al. 2021

BMC Surg

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Background/Purpose To investigate the clinical manifestations, treatments of retrograde intussusception and summarize the experience. Methods Children with retrograde intussusception treated in our hospital from January 2011 to January 2021 were retrospectively analysed. Demographics, clinical manifestations, preoperative colour Doppler ultrasound (CDU) findings, findings during surgery and follow-up results were collected. Results A total of 4719 cases of intussusception were treated in our department, including 12 cases of retrograde intussusception (0.25%). There were 8 males and 4 females.The age ranged from 4.1 to 14.3 months, with an average of (8.3 ± 2.8) months.; The weight ranged from 5.5 to 12.6 kg, with an average of (9.4 ± 2.3) kg; The onset time ranged from 6 to 15 h, with an average of (10.0 ± 2.4) h. All the children received CDU examination before surgery, and in one case, the possibility of 2 intussusception masses was considered. Emergency surgical exploration was performed after the failure of air enema reduction. During the operation, multiple types of intussusception were found (coincidence of anterograde and retrograde intussusception). The pattern of anterograde intussusception was all ileo-ileo-colic variety and the retrograde intussusception was proximal sigmoid colon into descending colon. All the children were successfully reduced by manual reduction without intestinal necrosis or intestinal malformation. All children were discharged 6–7 days after surgery, and had no recurrence after 3–6 months of follow-up. Conclusions Retrograde intussusception is easily misdiagnosed before surgery. During air enema, if the intussusception mass was fixed and did not move with increasing pressure, we should be aware of the possibility of retrograde intussusception, and the enema pressure should not be too large to avoid intestinal perforation. If the intraoperative position of the intussusception mass was not consistent with that of the preoperative enema, it was recommended to use bimanual examination to explore whether there was still a mass in the abdominal cavity to avoid misdiagnosis.

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Section: Discussionmentioning

confidence: 99%

The diagnosis and treatment of retrograde intussusception: a single-centre experience

Zhang

Liu

et al. 2021

BMC Surg

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“…Anastomotic leaks were only observed in 3 patients as this is usually an early postoperative event. Intussusception, here treated in 2 patients, is an uncommon condition thought to be caused by peristaltic waves becoming asynchronous because of the altered anatomy [27,28].…”

Section: Discussionmentioning

confidence: 99%

Abdominal pain after gastric bypass in the acute general surgical care setting

Zaigham

Ekelund

Regnér

et al. 2020

Surgery for Obesity and Related Diseases

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Background: Managing acute abdominal pain in the large and growing population of Roux-en-Y gastric bypass (RYGB)-operated patients poses a challenge to general surgeons, because of diagnostic limitations and the risk of internal herniation. Objective: To investigate the diagnoses, management, and outcome of RYGB patients admitted for acute abdominal pain. Setting: University Hospital, Sweden. Methods: Prospective inclusion of 280 consecutive RYGB patients admitted for acute abdominal pain between April 2012 and June 2015. Readmissions, surgical procedures, and overall mortality were recorded until October 2018. Medical records were retrospectively reviewed for anthropometric measures, medical history, time from RYGB surgery, and previous closure of mesenteric gaps. Admissions were separated into early (30 d) or late (.30 d) after RYGB. Procedures performed were categorized as follows: RYGB complication, other surgery, or unremarkable laparoscopy. Patients discharged with diagnosis of unspecified abdominal pain were separately analyzed. Diagnostic investigations, bariatric competency, on call surgery, surgical complications, and length of stay were registered. Results: In late admissions, the cause of the abdominal complaints remained unexplained in 127 of 262 (48%) patients despite 95 abdominal computed tomographies and 28 diagnostic laparoscopies. Emergency surgery was performed in 128 of 262 (49%) patients. RYGB complications (n 5 66), mainly internal herniation (n 5 42), were .2 times more frequent than other surgical procedures (n 5 32), such as cholecystectomies (n 5 23). Internal herniation could occur at any time interval from RYGB surgery and regardless of previously closed mesenteric gaps. Conclusion: Better tools for evaluation of acute abdominal pain in RYGB patients are needed to reduce the number of unremarkable laparoscopies and admissions of patients with unspecified abdominal pain.

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“…A maioria das intussuscepções após o RYGB ocorre no local da jejunojejunostomia e são retrógradas. O comprimento da jejunojejunostomia maior que 60 mm pode estar associado à ocorrência de intussuscepção 9 . A maioria dos pacientes requer intervenção cirúrgica, a ressecção e revisão da jejunojejunostomia são obrigatórias na presença de intestino delgado isquêmico ou não redutível.…”

Section: Desenvolvimentounclassified

“…A maioria dos pacientes requer intervenção cirúrgica, a ressecção e revisão da jejunojejunostomia são obrigatórias na presença de intestino delgado isquêmico ou não redutível. Os pacientes menos agudos podem ser tratados com redução laparoscópica e enteropexia após a redução 9 . A imbricação da anastomose jejunojejunal também foi proposta como um método para reduzir as recorrências.…”

Section: Desenvolvimentounclassified

“…A diminuição da ingestão oral, bem como a absorção alterada de alimentos do estômago e do intestino delgado, reduzem a absorção de vários micronutrientes, particularmente ferro, cálcio, vitamina B12, tiamina e folato. A hiperoxalúria e nefrolitíase foram relatadas após cirurgia de bypass gástrico em Y de Roux 9,10 . Estudos relataram encefalopatia hiperamonêmica em pacientes que não apresentam melhora do crescimento após cirurgias gastrointestinais complicadas que podem incluir RYGB.…”

Section: Desenvolvimentounclassified

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Evidências científicas sobre as complicações tardias da cirurgia bariátrica / Evidência científica das complicações tardio da cirurgia bariátrica

Rocha¹,

Borges²,

Gonçalves³

et al. 2022

Braz. J. Hea. Rev.

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RESUMOO bypass gástrico em Y-de-Roux é um dos procedimentos para perda de peso mais comuns realizados. As complicações do bypass gástrico em Y-de-Roux são diversas e incluem distensão gástrica remanescente, estenose estomacal, formação de úlcera marginal, colelitíase, hérnias ventrais, hérnias internas, obstruções do intestino delgado, hipoglicemia, dumping, distúrbios metabólicos e nutricionais, fístulas gastrogástricas e recuperação de peso . Algumas complicações são observadas durante os períodos pós-operatórios iniciais, enquanto outras podem surgir de semanas a meses após a cirurgia. As complicações da gastrectomia vertical laparoscópica incluem sangramento, estreitamento ou estenose do estoma, vazamentos e refluxo. As complicações da gastroplastia com faixas verticais incluem ruptura da linha de grampos, estenose estomacal, erosão da faixa, refluxo, náuseas, vômitos, úlceras marginais e recuperação de peso. As complicações do desvio biliopancreático incluem desnutrição protéico-calórica significativa, anemia, doença óssea metabólica e deficiências de vitaminas lipossolúveis e vitamina B12.

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S054: incidence and management of jejunojejunal intussusception after Roux-en-Y gastric bypass: a large case series

Cited by 24 publications

References 13 publications

The diagnosis and treatment of retrograde intussusception: a single-centre experience

The diagnosis and treatment of retrograde intussusception: a single-centre experience

Abdominal pain after gastric bypass in the acute general surgical care setting

Evidências científicas sobre as complicações tardias da cirurgia bariátrica / Evidência científica das complicações tardio da cirurgia bariátrica

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