Andrew M Martin, MD, Brandon M Smith, MD, John G Zografakis, MD. Summa Health System/NEOMED
This video presentation demonstrates the work up, diagnosis, and treatment of a patient with history of Laparoscopic Roux-En-Y gastric bypass who presents with a retrograde jejunal intussusception of the common channel. This particular patient had LRYGB with jejunojejunal anastomosis created using a triple staple technique. As opposed to the double staple technique, the triple staple technique results in a wider lumen and thus lower rates of stricture complications. However, the wider opening does place patients at higher risk of intussusception. While intussusception following LRYGB is a relatively common imaging finding, it is rarely clinically significant. Therefore, clinically significant JJ intussusception is an infrequent diagnosis, yet common enough that physicians may be required to manage this complication during their career and thus should be considered as a differential diagnosis for gastric bypass patients presenting with pain and obstructive symptoms. Definitive management includes operative intervention for reduction of the intussusceptum and assessment of bowel viability. This presentation describes the work up from the emergency room, key diagnostic steps, a video of surgical intussusceptum reduction, and surgical steps taken to limit intussusception recurrence. Overall, this video presentation serves as a diagnosis review and management demonstration to prepare physicians for management of retrograde jejunal intussusception following Laparoscopic Roux-En-Y gastric bypass.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95542
Program Number: V227
Presentation Session: Video Loop Day 2
Presentation Type: VideoLoop