1-Introduction
Bariatric surgery (BS) is considered the most efficient long-term therapy for morbid obesity (1). Laparoscopic classic gastric bypass is generally considered a safe and effective procedure to prevent long-term complications of morbid obesity (2). Some complications such as bleeding, anastomosis stricture, marginal ulcers, leakage from the anastomosis site, and intussusception(2) have been reported after gastric bypass (2, 3).
Intussusception is rare in adults accounting for just 5% of cases and usually is due to an underlying pathology (like tumors or inflammatory processes, and polyps) acting as a lead point causing invagination of the proximal part of the bowel into the distal alongside peristalsis (anterograde) accountable for 90% of all intussusception (4). Retrograde intussusception mostly follows bariatric surgery (5). In the classic gastric bypass, the distal bowel (common channel) is drawn into the lumen of the proximal bowel (alimentary limb or jejunojejunostomy anastomosis). These intussusceptions usually occur without a leading point and may represent a motility disorder following the Roux-en-Y reconstruction, which may requires surgical reductions (6).
Diagnosis of intussusception is difficult due to its presentation with a wide range of symptoms and various severity, including acute or chronic abdominal pain and obstructive symptoms, and laboratory test results are not specific (7, 8). In this study, we represent a 19-year-old lady with an unusual presentation of intussusception presenting as upper gastrointestinal bleeding (Hematemesis), which can cause misdiagnosis.