Intussusception - A Long Term Post Op RNY Complication

Godsvirtuoswoman
on 5/5/11 2:10 am - Milwaukee, WI
This graphic brings back memories...... Just this past January (2.5 yrs post-op) i began to experience intense - periodic pain in my lower right side.  I thought it was my appendix (location) but after a CAT scan, the intussusception was discovered on my right side just below my rib cage.  The also gave me an  Upper GI w/ lower bowel scan; you know when you drink the chalky stuff and they watch it move through on the x-ray screen (let's not discuss the constipation from the chalky stuff)-it was unnecessary because the problem was revealed on the CAT.

Anyway, my primary sent me to my bypass surgeon, who scheduled my corrective surgery the next week.  It was performed laproscopic through my navel and 2 other "gunshots"  and it hurt more than my original surgery. It was done outpatient, but  I didn't expect to be off work for a month; but the rest was needed.  My navel area was swollen and bruised; I felt like a big man w/ work boots kicked me in the gut.  But, I haven't had any pains/problems/trouble since the surgery.

It was strange that the problem was on the left but the pain was on the right-i forgot what they called it. It is true, the intussusception comes and goes; my surgeon says it was actually intussepting during the surgery so he was able to pinpoint exactly where the problem was. 

YAY!
I'm glad I got it corrected because my surgeon says sometimes it intussepts and gets stuck causing you greater pain and they actually have to remove that entire section of your intestine and resect the two ends (open surgery, longer hospital stay, longer recovery) no thanks

Kim

 
KIM
      
So Blessed!
on 5/5/11 2:48 am

I'm glad everything turned out all right for you.

I think the term you might be looking for is Referred Pain.  One example many people are familiar with is having pain in radiating down the neck and arm when having a heart attack.
vervetoloose
on 5/5/11 2:37 am
Yes, if the intussusception remains for to long with the blood supply compromised that portion of bowel can become necrotic and would then have to be removed.  This is why it is important not to  ignore abdominal pain.
            

" Oh you who love clear edges more than anything...........watch the edges that blurr."
 
So Blessed!
on 5/5/11 2:50 am

I explained my pain away for a long time, mainly because it would eventually go away and I hate being a whiner.  If it ever happens again, I'm making a beeline to the ER.

Sharyn S.
on 5/5/11 6:13 am - Bastrop, TX
RNY on 08/19/04 with
Intussusception is a complication of ANY abdominal surgery.

Sharyn, RN

RIP, MOM ~ 5/31/1944 - 5/11/2010
RIP, DADDY ~ 9/2/1934 - 1/25/2012

So Blessed!
on 5/5/11 6:26 am

I knew that intestinal obstructions in general are a potential complication of any abdominal surgery, but not this one in particular.  Your information is new to me.  I will look for studies and post.  Thanks.
So Blessed!
on 5/5/11 10:38 pm
Ann Hepatol. 2011 Jan 3;10(1):38-42.

Liver transplantation: A new risk factor for intestinal intussusceptions.

Pischke S, Karsten W, Hadem J, Schmidt S, Heiringhoff Heinz K, Helfritz F, Strassburg CP, Lobers J, Zender L, Tutarel O, Wedemeyer J, Manns MP, Wedemeyer H, Rifai K, Gebel M.

Source

Hannover Medical School, Gastroenterology, Hepatology and Endocrinology, Germany. [email protected]

Abstract

BACKGROUND:

Intestinal intussusception in adults is associated with chronic inflammatory bowel disease, celiac disease, abdominal tumors or previous abdominal surgery but most often of unknown origin.

AIM:

The aim of our study was to evaluate cir****tances and identify risk factors for intussusceptions.

METHODS:

All 65,928 abdominal ultrasound examinations performed at our tertiary medical center between January 2001 and June 2008 were analyzed retrospectively for the diagnosis "intussusception". After identifying individuals with sonographically proven intussusception we analyzed various patients' characteristics including age, gender and underlying disease as well as sonographic findings such as localization of the intussusception, absence or presence of ascites and lymph nodes.

RESULTS:

We identified 32 cases of intussusceptions [mean age 45 years (range 18 to 88); 18 patients were male]. Twelve patients (38%) had a history of abdominal surgery including 8 patients who had undergone liver transplantation (2 patients with primary sclerosing cholangitis, 1 patient with cystic fibrosis, 1 patient with sarcoidosis, 1 patient with hepatocellular carcinoma and HCV infection, 1 patient with autoimmune hepatitis, 1 patient with Crigler-Najar-syndrome and one patient with echino****us). A hepaticojejunostomy had been performed in 4 of the patients after liver transplantation. Liver transplanted patients were significantly overrepresented in the intussusceptions group compared with the overall cohort of patients undergoing abdominal ultrasound examination (25% vs. 8%, Chi-Square-test, p = 0.0023).

CONCLUSION:

In our retrospective study liver transplantation, in particular with hepaticojejunostomy, was identified as a new major risk factor for intestinal intussusceptions.

Laura S.
on 5/5/11 12:33 pm
Thanks for posting this.  I have had bouts of pain and my surgeon informed me of this. Scary!

Laura
      

 


          

                                           
blondierebel
on 7/29/11 1:33 pm
ok so it as been many many years since I have been here... I was diagnosed with this on Wednesday and saw a surgeon today on it.  Im freaking out and reading anything I can on it.

For those who have had this and had surgery... how was it for you?  recovery?

Roux-En-Y Gastric Bypass
2001
 

    
So Blessed!
on 8/1/11 11:14 pm

What is your surgeon's plan?
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