胃切除術後37年目に発症し腹部CT検査が有用であったBraun吻合部腸重積の1例

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  • INTUSSUSCEPTION INTO THE BRAUN'S ANASTONOSIS OCCURRED 37 YEARS AFTER GASTRECTOMY

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A case of retrograde intussusception into Braun's anastomosis is reported.<br>A 59-year-old man was admitted to the hospital because of sudden epigastric pain, distention and hematemesis. He had a previous history of undergoing a distal gastrectomy with gastrojejunostomy and Braun's anastomosis for gastric ulcer 37 years before admission.<br>There were distention and tenderness in the upper abdomen. With a diagnosis of intussusception based on an abdominal CT scan, an emergency operation was performed. Upon laparotomy, the jejunum retrogradely invaginated into the Braun's anastomosis. A resection of the jejunum including the Braun's anastomosis was carried out. The postoperative course was uneventful, and the patient was discharged from the hospital 16 days after the operation.<br>Anastomotic intussusception after gastrectomy is a rare postoperative complication, especially that into Braun's anastomosis. Most intersussuseptions occur within one month after operation, but some like in this case occur suddenly after elapsing for more than 10 years. Diagnostic endoscopy, upper GI series, abdominal CT and ultrasonography are useful, and in this case, abdominal CT that revealed layer structure and target sign in the extremely dilated intestine was very valuable.

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