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Intussusception into the Enteroanastomosis After Billroth II Gastrectomy and Roux-en-Y Jejunostomy

Sonographic and CT Findings

Nancy Hammond1, Frank H. Miller1 and Mary Dynes2

1 Department of Radiology, Northwestern Memorial Hospital, Northwestern University Medical School, 676 N. St. Clair St., Ste. 800, Chicago, IL 60611.
2 Department of Radiology, Fairview Hospital, 18101 Lorain Rd., Cleveland, OH 44111.



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  		Fig. 1A. —38-year-old woman with severe abdominal pain, nausea, and hematemesis due to intussusception. Transverse sonogram shows large complex mass with mushroom appearance, representing intussusceptum that is surrounded by hypoechoic outer layer, the intussuscipiens (arrows).

 


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  		Fig. 1B. —38-year-old woman with severe abdominal pain, nausea, and hematemesis due to intussusception. Longitudinal sonogram reveals hypoechoic and hyperechoic portions, representing alternating layers of mucosa, bowel wall, and mesenteric fat. Intussusceptum is composed of mesenteric fat (arrow) and collapsed bowel and is surrounded by hypoechoic outer rim (intussuscipiens).

 


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  		Fig. 1C. —38-year-old woman with severe abdominal pain, nausea, and hematemesis due to intussusception. Contrast-enhanced CT scan obtained 4 hr after sonography shows complex mass with central fat attenuation and enhancing foci representing intraluminal mesenteric fat (white arrow). Note enhancing mesenteric vessels (black arrow) centrally within intussuscipiens. Also note that proximal small bowel is dilated.

 


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  		Fig. 1D. —38-year-old woman with severe abdominal pain, nausea, and hematemesis due to intussusception. Contrast-enhanced axial CT scan reveals intraluminal mesenteric fat of intussusceptum (arrow).

 

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