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Retrograde jejunogastric intussusception

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Abstract

RETROGRADE jejunogastric intussusception occurs rarely after operations on the stomach. In the American literature only 45 cases have been reported. Although the complication was observed and described much earlier,1 a report on the radiologic diagnosis was published in 1924.1 On the basis of previously recorded cases, it has been established that retrograde jejunogastric intussusception is a late complication of gastrojejunostomy or of a Billroth II anastomosis, predominantly of the latter procedure.2 We believe that in view of the infrequency of reported instances of this complication after operations so commonly and widely performed, the report of a recent case is of special interest.

The declining incidence of cancer of the stomach in the United States,3 together with a trend toward a more physiologic operation for peptic ulcer disease will certainly make retrograde jejunogastric intussusception even rarer than it has been to the present time.

Report of a Case

A 60-year-old Negro man who had undergone partial gastrectomy and Billroth II anastomosis for peptic ulcer in 1948, was first examined at the Cleveland Clinic Hospital in March 1965 because of a three-year history of recurrent episodes of bilious vomiting and abdominal distension, occurring every two or three weeks and lasting about four days. Frequent urination preceded emesis, which was accompanied and followed by epigastric pain. Between attacks he felt well, but he had lost 13 pounds during the course of his illness. His family history and a review of systems were noncontributory.

On examination, the patient was ill-nourished, dehydrated, and depressed, weighing . . .


 

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