Video case reportLaparoscopic reduction of small bowel intussusception in a 33-week pregnant gastric bypass patient: surgical technique and review of literature
Section snippets
Case report
A 25-year-old, 33-week pregnant patient was transferred to our institution with bilious vomiting and abdominal pain. Her past medical history was significant for substance abuse and depression. Her past surgical history included cesarean section in 2003, Roux-en-Y gastric bypass in 2004, and laparoscopic cholecystectomy. On physical examination, her abdomen was distended as expected for a pregnant woman but with minimal peritoneal signs. Computed tomography of the abdomen, obtained at an
Discussion
Unlike pediatric patients, small bowel intussusception in the adult population is a rare etiology of small bowel obstruction. Intussusception in children is usually idiopathic [11]. In contrast, intussusception in adults is related to the presence of a mass that acts as a leading point.
With the increase in the number of gastric bypass operations performed for morbid obesity, small bowel intussusception, as a complication of bariatric surgery, has been more frequently reported [4], [5], [12],
Conclusion
Small bowel obstruction due to intussusception is a rare complication that can occur after gastric bypass surgery, as well as during pregnancy. Early diagnosis and intervention are of outmost importance to avoid irreversible bowel ischemia and sepsis. Ultrasonography and computed tomography are the modalities of choice for a radiologic diagnosis, but these are not always necessary. Careful inspection of the bowel on exploration is imperative to rule out other sources of obstruction.
Disclosures
The authors claim no commercial associations that might be a conflict of interest in relation to this article.
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