Fabio Pacifico1*, Maurizio Russo1, Michele Schettino1, Federica Mastella1, Giovanni Fontanella2 and Francesco Giuseppe Biondo1
1Department of General Surgery, Sacred Heart of Jesus Hospital, Italy
2Department of Radiology, Sacred Heart of Jesus Hospital, Italy
Single Anastomosis Jejuno Ileal Bypass (SAJI) is an option in conversion bariatric surgery for
patients with Deficient Weight Loss (DWL) or Weight Regain (WR) after Laparoscopic Roux-En-Y
Gastric Bypass (L-RYGB). We present a case of simultaneous anterograde intussusception, twist/
volvulus and internal hernia of the blind jejunal limb as a complication following SAJI. A 41-yearold
female was re-operated on in urgency, 40 days post-laparoscopic SAJI. Adhesiolysis, untwisting
the small bowel, internal hernia and intussusception reduction were successfully carried out. A
segmental blind limb was removed. This triad is a possible complication as in primary bariatric
surgery also in redo surgery, therefore performing SAJI we recommend to close the new mesenteric
defect by absorbable suture and to routinely fix the blind limb. In alternative to remove it if greater
than 50 cm in length.
Intussusception; Volvulus; Internal hernia; Conversion surgery; SAJI; S-RYGB
Pacifico F, Russo M, Schettino M, Mastella F, Fontanella G, Giuseppe Biondo F. A Singular Case of Anterograde Intussusception, Internal Hernia and Volvulus of the Blind Limb after Conversion Surgery to SAJI for Failed L-RYGB. World J Surg Surgical Res. 2020; 3: 1228..