Background

In the setting of prior gastric bypass surgery, here we describe a rare case of intussusception of the remnant stomach after 16 years.

Methods

A 62-year-old female patient with BMI (35.7) who underwent a laparoscopic roux-en-y gastric bypass 16 years ago, presented with chronic, crampy, epigastric pain. The CT scan showed a small amount of contrast reflux into the duodenum. A small bowel enteroscopy showed the gastric antrum prolapsing into the duodenal bulb with biopsies negative for malignancy.

Results

The patient underwent a laparoscopic subtotal gastrectomy of the remnant stomach. The patient did well postoperatively and was discharged the next day. Pathology demonstrated gastropathy and duodenal metaplasia. In follow up, the patient had resolution of her abdominal pain symptoms.

Conclusions

Gastroduodenal intussusception after gastric bypass surgery is rare. In literature review of roux-en-y gastric bypass, there was only one other case report in which the patient had a prior gastric plication. This complication can easily go unrecognized and the workup can be costly if not found early. Advances of double balloon enteroscopy, diagnostic laparoscopy, and a clinical high index of suspicion remains the most valuable diagnostic tool in patients with suspected intussusception.