Images in Radiology

Large Intussusception after Total Gastrectomy

75-year-old man who had previously undergone laparoscopic total gastrectomy for gastric cancer visited the emergency department because of acute severe abdominal pain. Abdominal CT showed an intussusception at the jejunojejunal anastomosis (Figure). Diagnostic laparoscopy was performed. Manual reduction was performed and demonstrated an approximately 30-cm jejunum intussusception. After reduction, the bowel remained congested, and smallbowel resection was performed. Anastomosis of the remaining jejunum was performed with a side-to-side method using automatic staplers in a fashion similar to that used for laparoscopic jejunojejunostomy in Roux-en-Y reconstruction (1). This is a rare condition, with a reported incidence of less than 0.1% after gastrectomy (2). The patient’s hospital course was uneventful, and he was discharged 4 days later.