Postoperative Jejuno-Jenunal Intussusception ? A Rare Complication Following Total Gastrectomy

Intussusception commonly occurs in pediatric age group where the etiology is idiopathic, in contrast to adults, where aetiology if often found. Ileocolic intuscusception is the most common type, but colocolic type is common in adults. Intussusception is a common cause of intestinal obstruction, but its occurrence in the post-operative period after bowel surgery is infrequent except for retrograde jejuno-gastric intussusception. We present here an unusual case of jejuno-jejunal intussusception in a 60 year old man who had undergone total gastrectomy with D2 nodal dissection and Roux-en-Y oesophagojejunostomy presenting with features of subacute intestinal obstruction, gastrointestinal bleeding and sepsis 2 weeks after surgery. He was evaluated by barium meal follow through examination. Surgery was offered in the fourth post-operative week in the form of manual reduction of the intussusception and peritoneal toileting after 2 days of conservative trial. Follow-up is necessary as possibility of recurrence cannot be excluded.