INCIDENCE OF JEJUNOGASTRIC INTUSSUSSCEPTION FOLLOWING GASTRIC SURGERY IN OUR HOSPITAL

Prof Dr.T.Karunaharan; Dr.V.Sujatha; Dr. D.Uma

Volume : VIII, Issue : III, March - 2018

INCIDENCE OF JEJUNOGASTRIC INTUSSUSSCEPTION FOLLOWING GASTRIC SURGERY IN OUR HOSPITAL

Prof Dr. T. Karunaharan, Dr. V. Sujatha, Dr. D. Uma

Abstract :

INTRODUCTION:Jejuno gastric intussusception as a complication following gastrectomy occurs at an incidence of 0.1%. It follows several types of gastric surgeries like Billroth 2 and gastro jejunostomy. The mortality of the patient usually confirms to the 10% range but a high mortality of 50% has been reported in cases of delayed diagnosis paired with late intervention. In order to bypass the morbidity of the condition timely surgical invervention is the rule of the day. Though the history of gastric surgery may point towards the diagnosis, preoperative anticipation or the same has proven to be difficult in most of the cases

AIMS AND OBJECTIVES: To study the incidence of jejunogastric intussusception following gastric surgery in KAPV medical college Tiruchirappalli during 10 years period from 2006 to 2016.The need for early intervention to prevent mortality and investigations needed to diagnose intussusception.

METHODS AND MATERIALS: 50 patients who underwent gastrojejunostomy in KAPV medical college Tiruchirappalli during the period 2006 to 2016 were taken up for study. . Patient demographics, clinical presentation, diagnosis, investigations, operative notes, management and histopathology reports were reviewed and data was collected from case records from medical records department.

RESULTS AND OBSERVATIONS: There were 5 cases of JGI. All were males. The mean age at presentation was 54.69 years (range 46–62). All patients presented with hematemesis or coffee ground vomiting. In addition, 3 patients had pain abdomen and 2 patients had malena. . All patients underwent surgical management. Most common type was Type II (efferent loop) seen in 3 patients. Type III (combined type) was seen in 1 patient. One patient had Type I (afferent loop).

CONCLUSION: JGI is a rare complication after gastrojejunostomy. Upper gastrointestinal endoscopy is diagnostic. Ultrasound and computed tomography of abdomen can of additional help. This complication can occur years after surgery. High index of suspicion is required for diagnosis. Prompt surgical intervention, still remains the main stay of treatment