Jejuno-gastric intussusception

Jejuno-gastric intussusception (JGI) is a rare complication of operations in which the stomach is anastomosed to the jejunum, since it has been reported after gastroenteroanastomosis and after all types of reconstructive surgery using a Billroth II method. The incidence of this pathology has been estimated as being one case in every 1500 gastric resections and/or gastroenteroanastomosis. Endoscopic assessment is a vital step in the choice of the method of treatment. Even in acute forms, it is possible to carry out parasurgical therapy using endoscopy to reduce invagination. When the characteristics of the intussusceptum make the involvement of the jejunal loop appear likely, surgery is the treatment of choice. The most appropriate method is the removal of the jejuno-gastric anastomosis, irrespective of whether this is a gastroenteroanastomosis or a Billroth II gastrojejunostomy, and the construction of a pyloroplasty or a gastroduodenostomosis according to Billroth I. Recurrent jejuno-gastric intussusceptions resolve spontaneously, sometimes without even being diagnosed. Endoscopic parasurgical treatment can be attempted if the intussusceptum is not impaired. The outcome of jejuno-gastric invagination depends on the immediacy and correctness of diagnosis.