Jejuno-gastric Invagination After Billroth II Gastrectomy

A 69-year-old patient with a history of partial gastrectomy due to a gastroduodenal ulcer came to our emergency department with abdominal pain. Physical examination detected a distended abdomen with diffuse pain. Computed tomography identified the invagination of a long section of mesentery and jejunum in the gastric remnant (Figs. 1 and 2) with defined gastric dilatation that reached the pelvis (Fig. 1). During surgery, we found a jejuno-gastric invagination through a large gastrojejunal anastomosis with dilatation of the gastric remnant. We performed disinvagination and fixation of the efferent loop on the right antero-lateral wall. The patient presented and uneventful recovery with no complications.

Fig. 1

Fig. 2