Antiperistaltic and isoperistaltic intussusception associated with abnormal motility after Roux-en-Y gastric bypass: a case report

Antiperistaltic and recurrent intussusceptions are extremely rare in the adult. We report a patient with both. The patient developed an antiperistaltic intussusception distal to her Roux enteroenterostomy years after a Roux-en-Y gastric bypass for morbid obesity. The diagnosis was made preoperativel...

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Bibliographic Details
Published inSurgery Vol. 110; no. 1; p. 109
Main Authors Hocking, M P, McCoy, D M, Vogel, S B, Kaude, J V, Sninsky, C A
Format Journal Article
LanguageEnglish
Published United States 01.07.1991
Subjects
Adult
Female
Gastric Bypass - adverse effects
Gastrointestinal Diseases - diagnostic imaging
Gastrointestinal Diseases - etiology
Gastrointestinal Motility
Humans
Intussusception - diagnostic imaging
Intussusception - etiology
Obesity - surgery
Peristalsis
Postoperative Period
Radiography
Recurrence
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Summary:Antiperistaltic and recurrent intussusceptions are extremely rare in the adult. We report a patient with both. The patient developed an antiperistaltic intussusception distal to her Roux enteroenterostomy years after a Roux-en-Y gastric bypass for morbid obesity. The diagnosis was made preoperatively with gastrointestinal contrast radiography and ultrasonography. At surgery, the intussusception was reduced, and 12 inches of nonviable bowel was resected, with a functional end-to-end anastomosis. An isoperistaltic intussusception occurred in the early postoperative period just distal to the anastomosis. Manometric evaluation of the Roux limb after the second operation showed altered gastrointestinal motility, consisting of orad-propagated and aboard-propagated migrating motor complexes, minimal phase 2 activity, and lack of conversion to the fed pattern with a liquid meal. Although manometry was not performed before the development of the intussusception, our findings are consistent with the hypothesis that altered intestinal motility may contribute to the development of intussusception.
ISSN:0039-6060