Jejunogastric Invagination Complicated With Intestinal Necrosis

Jejunogastric intussusception (JGI) is an uncommon complication of gastric surgery. Its causes are varied, and it is classified as acute or chronic depending on the time of onset. The clinical presentation is usually nonspecific, with symptoms such as epigastric pain, nausea, vomiting (with or without blood), and signs of upper gastrointestinal obstruction, which can be mistaken for neoplastic disease or peptic ulcer disease. The diagnosis is established by endoscopy or radiology, with computed tomography (CT) being particularly useful for defining the site of intussusception by demonstrating the typical findings of a target or pseudokidney appearance, as well as for quickly defining the extent and complications. Treatment usually requires urgent surgery to reduce the intestinal intussusception, assess the viability of the intestine, and, if necessary, perform an intestinal resection. Surgical outcomes depend on the duration of the condition, with a reported mortality rate of 5%-50% if treatment is delayed for more than 48 hours, a recurrence rate of up to 10% if the cause is not corrected, and prolonged hospital stays with extensive intestinal resections. We present a case of a patient with an unclear history of surgery for a perforated peptic ulcer complicated by JGI and intestinal ischemia.