Intussusception is a rare etiology of bowel obstruction in adults and accounts for 1–3% of those cases. It is associated with an underlying mass such as a tumor or polyp in >80% of patients [
- Penney D.
- Ganapathy R.
- Jonas-Obichere M.
- El-Refeay H.
Intussusception: a rare cause of abdominal pain in pregnancy.
Ultrasound Obstet Gynecol. 2006; 28: 723-725
- Azar T.
- Berger D.L.
Ann Surg. 1997; 226: 134-138
- Begos D.G.
- Sander A.
- Modlin I.M.
The diagnosis and management of adult intussusception.
Am J Surg. 1997; 173: 88-94
4]. In gastric bypass patients, intussusception is an uncommon complication [
- Aston S.J.
- Machlfeder H.I.
Intussusception in the adult.
Am Surg. 1975; 41: 576-580
- Edwards M.A.
- Grinbaum R.
- Ellsmere J.
- Jones D.B.
- Schneider B.E.
Intussusception after Roux-en-Y gastric bypass for morbid obesity: case report and literature review of rare complication.
Surg Obes Relat Dis. 2006; 2: 483-489
6]. The common channel distal to the jejunojejunostomy is the usual site of intussusceptions. The direction of intussusception can be either antegrade or retrograde, but most reported cases are retrograde in nature. The probable etiology can include the presence of an ectopic pacemaker causing retrograde peristalsis. Alternatively, it is believed that dysmotility disorder can occur after Roux-en-Y gastric bypass owing to disruption of the pacesetter. Intussusception has also been reported to complicate pregnancy [
- Gerst P.H.
- Iyer S.
- Murthy R.M.
- Albu E.
Retrograde intussusception as a complication of Roux-en-Y anastomosis.
Surgery. 1991; 110: 917-919
- Connolly M.M.
- Unti J.A.
- Nora P.F.
Bowel obstruction in pregnancy.
Surg Clin North Am. 1995; 75: 101-113
- Moore D.T.
- Watts C.D.
- Wilbanks G.D.
Intussusception complicating pregnancy: report of a case.
J Natl Med Assoc. 1967; 59: 20-21
- Shenhav S.
- Gemer O.
- Segal S.
- Linova L.
- Joffe B.
Preoperative diagnosis of intestinal intussusception in pregnancy: a case report.
J Reprod Med. 2000; 45: 501-503
10]. Although it is a rare occurrence, intussusception can have devastating consequences if not promptly diagnosed and managed. The difficulty of reaching the diagnosis in pregnant patients, as well as the challenges of surgical management of a pregnant abdomen, increases the seriousness of such presentation.
- Perdue P.W.
- Johnson Jr, H.W.
- Stafford P.W.
Intestinal obstruction complicating pregnancy.
Am J Surg. 1992; 164: 384-388
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- Intussusception: a rare cause of abdominal pain in pregnancy.Ultrasound Obstet Gynecol. 2006; 28: 723-725
- Adult intussusception.Ann Surg. 1997; 226: 134-138
- The diagnosis and management of adult intussusception.Am J Surg. 1997; 173: 88-94
- Intussusception in the adult.Am Surg. 1975; 41: 576-580
- Intussusception after Roux-en-Y gastric bypass for morbid obesity: case report and literature review of rare complication.Surg Obes Relat Dis. 2006; 2: 483-489
- Retrograde intussusception as a complication of Roux-en-Y anastomosis.Surgery. 1991; 110: 917-919
- Bowel obstruction in pregnancy.Surg Clin North Am. 1995; 75: 101-113
- Intussusception complicating pregnancy: report of a case.J Natl Med Assoc. 1967; 59: 20-21
- Preoperative diagnosis of intestinal intussusception in pregnancy: a case report.J Reprod Med. 2000; 45: 501-503
- Intestinal obstruction complicating pregnancy.Am J Surg. 1992; 164: 384-388
- Laparoscopic versus open reduction of intussusception in children: a single-institution comparative experience.J Pediatr Surg. 2007; 42: 845-848
- Ectopic jejunal pacemakers and gastric emptying after Roux gastrectomy: effect of intestinal pacing.Surgery. 1989; 106: 867-871
- Antiperistaltic (retrograde) intussusception after Roux-en-Y gastric bypass.Am Surg. 2004; 70: 67-70
- Antiperistaltic and isoperistaltic intussusception associated with abnormal motility after Roux-en-Y gastric bypass: a case report.Surgery. 1991; 110: 109-112
- Intussusception caused by a carcinoma of the cecum during pregnancy: report of a case and review of the literature.Surg Today. 1993; 23: 556-561
- Use of magnetic resonance imaging in pregnancy to diagnose intussusception induced by colonic cancer.Obstet Gynecol. 1992; 79: 822-823
- Preoperative diagnosis of small-bowel intussusception in pregnancy with the use of sonography.J Ultrasound Med. 2005; 24: 1575-1577
- MRI of acute abdominal and pelvic pain in pregnant patients.AJR Am J Roentgenol. 2005; 184: 452-458
- Elective laparoscopy in diagnosis and treatment of recurrent small bowel obstruction.Surg Laparosc Endosc Percutan Tech. 2006; 16: 416-422
- Guidelines for Diagnosis, Treatment, and Use of Laparoscopy for Surgical Problems during Pregnancy.Accessed September, 2007)
- Laparoscopic reduction of intussusception: an evolving therapeutic option.JSLS. 2007; 11: 235-237
- Laparoscopic management of a nonobstetric emergency in the third trimester of pregnancy.Surg Endosc. 2007; 21: 1344-1348
Published online: September 19, 2008
Accepted: September 8, 2008
Received in revised form: August 3, 2008
Received: May 2, 2008
© 2009 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.