Navigation Links
Antegrade bowel intussusception can cause recurrent, chronic postoperative intestinal obstruction
Date:11/13/2007

Several complications can be seen after pancreatic surgery, most notably bleeding, infections and anastomotic dehiscence. Bowel obstruction can also be seen due to internal hernias or anastomotic strictures. A more unusual etiology for bowel obstruction in this setting is intussusception.

Intussusception is often a pediatric condition. Adult cases have rarely been reported, and are usually caused by a lead point. The paper published by Dr. Luis Leons group on the November 28 issue of World Journal of Gastroenterology describes a rare case of adult intussusception without lead points. Cases without lead points are most often seen after gastric bypasses for morbid obesity or after biliary reconstruction for choledochal cysts. Intussusception occurring after pancreatic duct reconstructions is rare. The report represents the second report in the literature of such an occurrence.

This patient was quite a challenge for surgeons at the University of Arizona. She was a middle-aged female who presented with abdominal pain and vomiting of 24-hour duration. Her history was significant for pancreas divisum and chronic pancreatitis. Four years prior, she underwent a Whipple procedure as therapy for her pancreatic abnormalities. The indications to perform a Whipple procedure to correct pancreas divisum are questioned by the authors in their paper. She required revision one year later with a Puestow operation due to stricture of the pancreatico-intestinal anastomosis. Ever since, she had been experiencing intermittent abdominal pain for which she had been prescribed strong pain killers, with only partial relief. Upon arrival at the University of Arizona, severe tenderness to abdominal palpation was elicited. Emergent surgical intervention was deemed necessary. An intussusception just distal to the most distal Roux-en-Y connection was found, causing two loops of dilated small bowel up to 10-cm in maximal diameter, and also about 1 foot of non-perforated necrotic small bowel. The intussusception was antegrade, obstructing both Roux-en-Y reconstructions. No lead point lesions were seen. The intussuscepted intestine was reduced, the necrotic bowel resected, and a side-to-side anastomosis between the most distal aspect of the bowel and the Roux-en-Y reconstruction that was directed towards the Puestow procedure was performed. She was subsequently discharged without complications.

The chronic nature and severity of this patients symptoms made her diagnosis very challenging. Previously performed CT scans showed findings that, in retrospect, suggest transient short bowel segment intussusceptions. The authors postulate that this complication may be a severe variant of Roux-en-Y stasis syndrome. The myoelectric activity of the Roux limb is often dysfunctional, split and retrograde and of high amplitude. It is possible that the intussusception seen in this patient was the result of severe disruption of the intestinal pacemaker activity, which is even more likely in the absence of lead points.

Antegrade intussusception after pancreatic surgery is extremely rare. This report by Dr. Leons group is the second such occurrence. Their patient had previous episodes of abdominal pain and vomiting, which suggests that altered intestinal motility may have contributed to her presentation. Intussusception should always be considered in cases of bowel obstruction in adults after pancreatic reconstructions.


'/>"/>

Contact: You-De Chang
y.d.chang@wjgnet.com
86-108-538-1892
World Journal of Gastroenterology
Source:Eurekalert

Related medicine news :

1. Elsevier announces new journal on inflammatory bowel diseases
2. C-diff infection 4 times more likely to kill patients with inflammatory bowel disease
3. Mesalamine linked to cancer protection for high risk inflammatory bowel disease patients
4. Threshold for bowel surgery may be too high, warn experts
5. Drug for cluster headaches may cause heart problems
6. Study Points to Cause of Vioxx Heart Risk
7. Damp, Moldy Homes May Cause Depression
8. Constipations Many Causes and Cures
9. High Co-Pays Cause Seniors to Go Without Meds
10. 13 percent of women stop taking breast cancer drug because of side effects, U-M study finds
11. Vocal cord dysfunction may be caused by work
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/7/2016)... , ... December 07, 2016 , ... ... 2016 BOC Business Brilliance Awards under the Best New Product Launch category. Gensuite’s ... achieved through user experience. , BOC Global Events & Training Group is a ...
(Date:12/7/2016)... ... ... “The Road To Restoration”: an informative and enlightening book for those who ... of hands. “The Road To Restoration” is the creation of published author, Thomas Fitzhugh ... ring that you could reach out for, and grab, on the old carousels. ...
(Date:12/7/2016)... ... 2016 , ... “Fred Rides a Train” allows readers to tag along on ... Rides a Train” is the creation of published author, Janet Morrison, who has been ... Michigan. The "Fred, the Dog" series is her first attempt at writing for children. ...
(Date:12/7/2016)... ... December 07, 2016 , ... Dr. Greg ... the International Probiotic Association’s Washington DC workshop on November 2nd. The conference was ... dialog regarding probiotic dietary supplement regulations. , Dr. Leyer spoke about two ...
(Date:12/6/2016)... ... 06, 2016 , ... People with Parkinson’s disease and cognitive ... type of MRI, according to a study appearing online in the journal Radiology. ... characterized by tremors or trembling and stiffness in the limbs, impaired balance and ...
Breaking Medicine News(10 mins):
(Date:12/6/2016)...  Alopexx Oncology, LLC announced data from a Phase ... (immunocytokine) composed of interleukin-2 and a CD20-targeting monoclonal antibody. ... cells as Rituxan and maintains the activities of both ... in tumor targeting, engagement of the immune system, and ... the study (abstract #95954) were presented at the 58 ...
(Date:12/6/2016)... -- Radioisotopes are radioactive isotopes having an unstable balance ... nuclear research reactor or by using cyclotron. These isotopes ... gamma when changed to a stable nature. The gamma ... in medical diagnostics. In this field, the radiation is ... functioning. Radiotherapy is also used to treat some life-threatening ...
(Date:12/6/2016)... Homozygous Familial Hypercholesterolemia (HoFH) - ... Global Markets Direct,s latest Pharmaceutical and Healthcare ... – Pipeline Review, H2 2016, provides an ... (Metabolic Disorders) pipeline landscape. Homozygous familial ... caused due to mutation from both parents. ...
Breaking Medicine Technology: