Rana M Higgins, MD, Jon C Gould, MD, Tammy L Kindel, MD, PhD. Medical College of Wisconsin
A 36 year-old morbidly obese female underwent a laparoscopic Roux-en-Y gastric bypass. Her BMI at the time of surgery was 53 kg/m2. She continued smoking and subsequently developed a marginal ulcer, for which she had a revisional gastrojejunostomy performed with remnant gastrostomy tube placement 1.5 years after her initial operation. She continued to struggle with recurrent marginal ulcers and chronic pain. She presented to the Emergency Department 2 years after her initial gastric bypass with 1 day of worsening abdominal pain, nausea and vomiting. A CT abdomen was performed demonstrating obstruction at her jejunojejunostomy and concern for an intussusception and internal hernia. She was taken urgently to the operating room for laparoscopic exploration. Intraoperatively, a small bowel intussusception was identified of the common channel limb retrograde into the jejunojejunostomy. With slow and gradual tension, the intussuscepted small bowel was able to be reduced, with a significant amount of edema released. Once the intussusception had been reduced, the bowel was inspected and noted to be viable. The jejunojejunostomy was identified and an enteropexy was performed of the common channel to the biliopancreatic limb. Post-operatively the patient recovered well and was discharged home on post-operative day 3, no longer requiring narcotic pain medications.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93785
Program Number: V294
Presentation Session: Video Loop Day 3
Presentation Type: VideoLoop