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.