A CASE OF JEJUNAL INTUSSUSCEPTION IN AN ADULT WHICH OCCURRED 11 YEARS AFTER TOTAL GASTRECTOMY

Intussusception is a rare complication after laparotomy which is ordinarily seen in an early postoperative phase. A case of jejunal intussusception in an adult which occurred 11 years after total gastrectomy is reported. A 71-year-old man, who underwent a total gastrectomy for a gastric carcinoma at the age of 60, was seen at the hospital because of abrupt epigastralgia and vomiting. Abdominal roentgenogram showed small intestinal gas and a CT scan demonstrated a concentric circle composed of dilated intestinal wall. With the diagnosis of intestinal obstruction, a laparotomy was performed. Intestinal tract had been reconstructed with Billroth II esophagojejunostomy and Braun anastomosis, and retrograde double intussusception of the jejunum was observed in the anal side of the Braun anastomosis. Intussuscepted jejunum was resected, which contained no tumor. It has to be considered that intussusception can occur and cause intestinal obstruction in some postgastrectomy patients even if many years have passed after the surgery.