1568 A Case of Small Bowel Intussusception Occurring Six Years After Laparoscopic RYGB

Abstract Introduction We present a case of small bowel intussusception occurring in female who had previously undergone Laparoscopic RYGB. Few reports retrograde pregnant patients with history LRYBG have been published. Up to our knowledge, this is the first rare complication presenting postnatal period. Case report Our patient, her thirties, gave birth healthy baby via caesarian section six years after LRYGB. On day following operation, she experienced epigastric severe, progressive abdominal pain associated nausea and vomiting. Abdominal examination showed left upper quadrant tenderness, hypoactive sounds no palpable masses. Small obstruction was suspected. A nasogastric tube inserted an CT scan oral contrast ordered. The multiple concentric segments loops representing intussusceptum pulled into intussuscipiens, giving classic doughnut sign. patient subsequently taken theatre for laparotomy. mass comprised biliopancreatic limb which dilated as common retrogradely intussuscepting it. ischemic remained so manual reduction. 45cm segment resected then primary re-anastomosis done. Her postoperative course unremarkable. Discussion Intussusception can original surgery, imaging not always reliable. Seeing bariatric surgery getting more popular, physicians should be well aware serious delay diagnosis increases morbidity mortality.