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Query: UMLS:C0021933 (intussusception)
 3,822 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intussusception involving the excluded small bowel segment is an infrequent complication following intestinal by-pass procedures for morbid obesity. Because the intussusception involves bowel not in continuity with the alimentary stream, the usual diagnostic clinical and radiographic patterns fail to appear and recognition is usually delayed. This paper reports in detail such a patient, who was relieved of prolonged abdominal pain by operation. Previously reported patients are reviewed.
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PMID:Intussusception of the by-passed segment after jejunoileal by-pass for obesity. A cryptic problem. 51 4

A man who had undergone jejunoileal bypass for morbid obesity had cramping abdominal pains for which no cause could be found, despite repeated clinical examinations and numerous investigations. Only during anesthesia could the large mass formed by the intussusception be palpated. Following reduction of the intussusception and refixing to the anterior abdominal wall, all symptoms abated.
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PMID:Intussusception following jejunoileal bypass for morbid obesity: report of a case. 64 90

In 600 patients who have undergone small bowel bypass for the treatment of morbid obesity, we have encountered three patients who developed intussusception in the bypassed intestine. Diagnosis in these cases has been difficult but in two patients with surgical marker clips applied to the transected fixed jejunum as well as to the adjacent mesocolon, diagnosis was made easier by the radiographic finding of separation of these clips. Clinical symptoms are difficult to evaluate and valuable time may be wasted before a diagnosis is arrived at. Once a diagnosis is made, operation with either reduction or resection of the area of intussusception should be carried out with refixation of the bowel to the mesocolon and reapplication of surgical marker clips. These marker clips are of great value in the diagnosis of intussusception occurring in the bypassed loop.
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PMID:Jejunal intussusception following small bowel bypass for morbid obesity. 84 34

Antiperistaltic and recurrent intussusceptions are extremely rare in the adult. We report a patient with both. The patient developed an antiperistaltic intussusception distal to her Roux enteroenterostomy years after a Roux-en-Y gastric bypass for morbid obesity. The diagnosis was made preoperatively with gastrointestinal contrast radiography and ultrasonography. At surgery, the intussusception was reduced, and 12 inches of nonviable bowel was resected, with a functional end-to-end anastomosis. An isoperistaltic intussusception occurred in the early postoperative period just distal to the anastomosis. Manometric evaluation of the Roux limb after the second operation showed altered gastrointestinal motility, consisting of orad-propagated and aboard-propagated migrating motor complexes, minimal phase 2 activity, and lack of conversion to the fed pattern with a liquid meal. Although manometry was not performed before the development of the intussusception, our findings are consistent with the hypothesis that altered intestinal motility may contribute to the development of intussusception.
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PMID:Antiperistaltic and isoperistaltic intussusception associated with abnormal motility after Roux-en-Y gastric bypass: a case report. 186 83

The consequences of jejunoileal bypass include not just metabolic derangements, though the frequency and severity of these problems have led to the procedure being abandoned in the treatment of morbid obesity, but a variety of mechanical complications as well. In this report, a new mechanical complication is presented: Intussusception of the defunctionalized ileum into the sigmoid colon, an intussusception caused by malignant lymphoma of the ileum. Because the patient had pain but no evidence of obstruction, the ileal tumor was fortuitously discovered during flexible sigmoidoscopy.
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PMID:A unique late mechanical complication of jejunoileal bypass. 405 80

Eighty patients who had undergone jejunoileal bypass for morbid obesity were examined by ultrasound at their routine follow-up visits to the clinic. Ultrasonographic evidence of intestinal intussusception was found in 15 patients (19%). Two of these patients were asymptomatic. Ultrasonographic findings were confirmed by operation in 6 patients (5 with intussusception, 1 negative).
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PMID:Intussesception after jejunoileal bypass as diagnosed by ultrasound. 725 Jun 27

Complications associated with jejunoileal bypass for morbid obesity are being recognized more frequently. A variety of mechanical obstructions in the defunctionalized small-bowel segment have recently been corrected in seven surgical patients. Volvulus of the defunctional limb was the most frequent cause of obstruction. Intussusception, bypass enteritis, fascial hernia, and adhesive bands were also causes of obstruction. Radiographic contrast studies were valuable in establishing the preoperative diagnosis. The altered small-intestinal anatomy predisposed these patients to a uniquely subtle and dangerous form of closed-loop obstruction. Prompt recognition was based on patient history and physical findings. Characteristic roentgenographic findings often confirmed the diagnosis. Clinical suspicision of these small-bowel obstructive syndromes may lead to early surgical treatment.
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PMID:Obstruction of defunctionalized small bowel: its occurrence after bypass surgery for morbid obesity. 741 49

Adult intussusception has been described after various types of gastrointestinal surgery. In some instances there may be intussusception of the jejunum into the stomach via a gastrointestinal stoma, a rare complication known as jejunogastric intussusception (JGI). We present a retrospective review of two cases of retrograde intussusception occurring years after open Roux-en-Y gastric bypass (RYGB) for morbid obesity. To our knowledge there have been no documented reports of JGI occurring after RYGB and only scattered reports of JGI after Roux-en-Y reconstruction in general. Two reports of intussusception following RYGB were identified in the English literature and comprised three patients, only one of whom suffered a retrograde intussusception. As the number of RYGB procedures continues to rise, we will likely see more of this entity; and it is therefore crucial that surgeons consider acute and chronic intussusception as a cause of abdominal pain in patients who have undergone RYGB.
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PMID:Antiperistaltic (retrograde) intussusception after Roux-en-Y gastric bypass. 1496 52

Although rare, patients with biliopancreatic diversion for morbid obesity will be subject to obstruction of the biliopancreatic limb. This condition is commonly due to postoperative adhesions and intussusception and usually presents with misleading clinical and radiographic features that can delay the diagnosis and the treatment. We recently encountered a patient with obstruction of the biliopancreatic limb due to involvement from Crohn disease. We report this case to highlight the clinical and imaging findings of this rare condition.
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PMID:Crohn disease obstruction of the biliopancreatic limb in a patient operated for biliopancreatic diversion for morbid obesity. 1636 11

Obstruction of the small intestine is a recognized complication after Roux-en-Y gastric bypass surgery for morbid obesity. Reported causes after bariatric surgery include volvulus, adhesion, internal hernia, hemorrhagic bezoar, incarcerated ventral hernia, and intussusception. Intussusception after Roux-en-Y gastric bypass for morbid obesity is rare. The etiology remains largely obscure. A delay in the diagnosis and management may result in catastrophic outcomes. Management should include the early involvement of a bariatric surgeon. We describe the clinical and radiologic presentation of a case of jejunojejunal intussusception 4 years after open Roux-en-Y gastric bypass.
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PMID:Intussusception after Roux-en-Y gastric bypass for morbid obesity: case report and literature review of rare complication. 1692 87


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