1107 Intussusception Following Duodenal Switch: A Case Report

Background Intussusception accounts for 1% of small bowel obstruction in adults. There have been several reports of intussusception following jejune-ileal bypass and Roux-en-Y gastrectomy. To our knowledge, this is the first reported case of intussusception following Biliopancreatic diversion with duodenal switch. Case Presentation We present a 32-year-old woman who had a biliopancreatic diversion with duodenal switch procedure for weight loss three years ago. She had successful outcomes and lost 100kgs after surgery. She presented with recurrent episodes of self-remitting severe colicky abdominal pain and vomiting. A CT scan showed an intussusception at the side-to-side ileo-ileal anastomosis. On laparoscopy, telescoping of the small bowel was identified, the alimentary limb had intussuscepted into the anastomosis. The telescoped bowel was gently reduced. The bowel was viable, and decision was made to avoid resection. The alimentary and the biliopancreatic limbs were plicated for 5cm proximally and distally to prevent recurrence. She recovered well after the operation and remained well on six months’ follow-up. Conclusions Intussusception is a rare but serious complication after bariatric surgeries. While management of intussusception in adults usually entails reduction and resection to remove the lead point, plication and enteropexy can be utilised to avoid bowel resection. This is of value when such patients present to a non-bariatric centre.