INTUSSUSCEPTION

The patient is a 51 years old female with multiple surgical histories including Gastric Bypass, Gastric Band, Removal of the band and multiple lysis of adhesion, who presented to the Emergency Room of our Hospital with the left upper quadrant pain associated with nausea and 10 episodes of vomiting and diarrhea. There was some tenderness to deep palpation in the periumbilical area with minimal distention of the abdomen. The patient had a white count of 14 and a CAT scan showing a Biliopancreatic Limb Obstruction at the site of previous Jejunojejunostomy with evidence of intussusception. Fig. 1 At that point the decision was made to take the patient to the Operating Room concerning for a Bowel Ischemia secondary to a closed loop bowel obstruction. The proposed surgery was diagnostic Laparoscopy, Small Bowel Resection and possible open. Risks and benefits of the procedure was explained to the patient. The patient was taken to the Operating Room after Pre Op clearance for the procedure.