Case Report
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 28, 2007; 13(44): 5954-5956
Published online Nov 28, 2007. doi: 10.3748/wjg.v13.i44.5954
Antegrade bowel intussusception after remote Whipple and Puestow procedures for treatment of pancreas divisum
Manuel Gigena, Hugo V Villar, Negar G Knowles, John T Cunningham, Erik K Outwater, Luis R Leon Jr
Manuel Gigena, Hugo V Villar, Negar G Knowles, John T Cunningham, Erik K Outwater, Luis R Leon Jr, University of Arizona Health Science Center, and Southern Arizona Veteran Affairs Health Care System, Surgery Section, Tucson, AZ 85723, United States
Author contributions: All authors contributed equally to the work.
Correspondence to: Luis R Leon Jr, MD, RVT, University of Arizona Health Science Center, and Southern Arizona Veteran Affairs Health Care System, Surgery Section, 3601 South 6th Avenue, Vascular Surgery Section Room N259, Tucson, AZ 85723, Arizona, United States. luis.leon@va.gov
Telephone: +1-520-7921450-16596
Received: June 15, 2007
Revised: August 31, 2007
Accepted: October 23, 2007
Published online: November 28, 2007
Abstract

To date, antegrade intussusception involving a Roux-en-Y reconstruction has been reported only once. We report a case of acute bowel obstruction due to an intussusception involving two Roux-en-Y limbs in a 40-year-old woman with a history of chronic pancreatitis due to pancreas divisum. Four years preceding this event, the patient had undergone a Whipple procedure, and three years prior to that, a Puestow operation. The patient was successfully treated with bowel resection and a side-to-side anastomosis between the most distal aspect of the bowel and the most distal Roux-en-Y reconstruction, which preserved both Roux-en-Y reconstructions.

Keywords: Whipple procedure, Puestow procedure, Pancreas divisum, Intussusception, Bowel obstruction