Skip to main content
Top
Published in: Obesity Surgery 8/2010

01-08-2010 | Case Report

Anterograde Intussusception Following Laparoscopic Roux-en-Y Gastric Bypass: A Case Report and Review of the Literature

Authors: Darcy Shaw, Stephen Huddleston, Gregory Beilman

Published in: Obesity Surgery | Issue 8/2010

Login to get access

Abstract

Intussusception is a rare but worrisome cause of bowel obstruction in patients following Roux-en-Y gastric bypass. When intussusceptions is discovered in the general adult population, most often there is a “lead-point”; however, following bariatric procedures, this may not be true. There appears to be an increased incidence of this condition in open compared to laparoscopic Roux-en-Y gastric bypass procedures. Intussusception is often difficult to diagnose, especially in this population. Symptoms and signs can be very vague, and even computed tomography may not be accurate in diagnosing this condition. A high index of suspicion is required to successfully diagnose intussusception, and treatment often requires exploration and bowel resection. Herein, we report a case that follows several of these trends and suggests other possible contributions to intussusception. We also review other cases of intussusception after laparoscopic gastric bypass reported in the literature.
Literature
1.
go back to reference Kuczmarski RJ, Flegal KM, Campbell SM, et al. Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA. 1994;272(3):205–11.CrossRefPubMed Kuczmarski RJ, Flegal KM, Campbell SM, et al. Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA. 1994;272(3):205–11.CrossRefPubMed
2.
go back to reference Sugerman HJ, DeMaria EJ, Kellum JM. Gastric surgery for morbid obesity. In: Nyhus LM, Baker RJ, Fisher JE, editors. Mastery of surgery. Boston: Little, Brown and Company; 1997. p. 982. Sugerman HJ, DeMaria EJ, Kellum JM. Gastric surgery for morbid obesity. In: Nyhus LM, Baker RJ, Fisher JE, editors. Mastery of surgery. Boston: Little, Brown and Company; 1997. p. 982.
3.
go back to reference Pories WJ, Swanson MS, MacDonald KG, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995;222(3):339–50. discussion 350–2.CrossRefPubMed Pories WJ, Swanson MS, MacDonald KG, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995;222(3):339–50. discussion 350–2.CrossRefPubMed
5.
go back to reference Higa KD, Ho T, Boone KB. Internal Hernias after laparoscopic Roux-en-Y gastric bypass: incidence, treatment, and prevention. Obes Surg. 2003;13(3):350–4.CrossRefPubMed Higa KD, Ho T, Boone KB. Internal Hernias after laparoscopic Roux-en-Y gastric bypass: incidence, treatment, and prevention. Obes Surg. 2003;13(3):350–4.CrossRefPubMed
6.
go back to reference Efthimiou E, Court O, Christou N. Small bowel obstruction due to retrograde intussusception after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2009;19:378–80.CrossRefPubMed Efthimiou E, Court O, Christou N. Small bowel obstruction due to retrograde intussusception after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2009;19:378–80.CrossRefPubMed
7.
go back to reference Simper S, Eerzinger J, McKinlay R, et al. Retrograde (reverse) jejunal intussusception might not be such a rare problem: a single group's experience of 23 cases. Surg Obes Relat Dis. 2008;4:77–83.CrossRefPubMed Simper S, Eerzinger J, McKinlay R, et al. Retrograde (reverse) jejunal intussusception might not be such a rare problem: a single group's experience of 23 cases. Surg Obes Relat Dis. 2008;4:77–83.CrossRefPubMed
8.
go back to reference Mehran A, Liberman M, Rosenthal R, et al. Ruptured appendicitis after laparoscopic Roux-en-Y gastric bypass: pitfalls in diagnosing a surgical abdomen in the morbidly obese. Obes Surg. 2003;13(6):938–40.CrossRefPubMed Mehran A, Liberman M, Rosenthal R, et al. Ruptured appendicitis after laparoscopic Roux-en-Y gastric bypass: pitfalls in diagnosing a surgical abdomen in the morbidly obese. Obes Surg. 2003;13(6):938–40.CrossRefPubMed
9.
go back to reference Edwards M, Grinbaum R, Ellsmere J. Intussusception after Roux-en-Y gastric bypass for morbid obesity: case report and literature review of rare complication. Surg Obes Relat Dis. 2006;2(4):483–9.CrossRefPubMed Edwards M, Grinbaum R, Ellsmere J. Intussusception after Roux-en-Y gastric bypass for morbid obesity: case report and literature review of rare complication. Surg Obes Relat Dis. 2006;2(4):483–9.CrossRefPubMed
11.
go back to reference Hocking MP, McCoy DM, Vogel SB, et al. Antiperistaltic and isoperistaltic intussusception associated with abnormal motility after Roux-en-Y gastricbypass: a case report. Surgery. 1991;110:109–12.PubMed Hocking MP, McCoy DM, Vogel SB, et al. Antiperistaltic and isoperistaltic intussusception associated with abnormal motility after Roux-en-Y gastricbypass: a case report. Surgery. 1991;110:109–12.PubMed
12.
go back to reference Goverman J, Greenwald M, Gellman L, et al. Antiperistaltic (Retrograde) intussusception after Roux-en-Y gastric bypass. Am Surg. 2004;70(1):67–70.PubMed Goverman J, Greenwald M, Gellman L, et al. Antiperistaltic (Retrograde) intussusception after Roux-en-Y gastric bypass. Am Surg. 2004;70(1):67–70.PubMed
13.
go back to reference Zainabadi K, Ramanathan R. Intussusception after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2007;17:1619–23.CrossRefPubMed Zainabadi K, Ramanathan R. Intussusception after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2007;17:1619–23.CrossRefPubMed
14.
go back to reference Tu BN, Kelly KA. Motility disorders after Roux-en-Y gastrojejunostomy. Obes Surg. 1994;4(3):219–26.CrossRefPubMed Tu BN, Kelly KA. Motility disorders after Roux-en-Y gastrojejunostomy. Obes Surg. 1994;4(3):219–26.CrossRefPubMed
15.
go back to reference Wax JR, Wolff R, Cobean R, et al. Intussusception complicating pregnancy following laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2007;17(7):977–9.CrossRefPubMed Wax JR, Wolff R, Cobean R, et al. Intussusception complicating pregnancy following laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2007;17(7):977–9.CrossRefPubMed
Metadata
Title
Anterograde Intussusception Following Laparoscopic Roux-en-Y Gastric Bypass: A Case Report and Review of the Literature
Authors
Darcy Shaw
Stephen Huddleston
Gregory Beilman
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 8/2010
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-009-0037-y

Other articles of this Issue 8/2010

Obesity Surgery 8/2010 Go to the issue