Question:
Reoccurring Intussusceptions. Please help!
I had a RNY bypass in January of 2003. In December of 2005 I had to have emergency surgery for an Intussusception and then again in February 2007. I am scared to death of it happening again for it is the absolute worst pain and is life threatning. I am wondering if anyone has had similar experiences and what advice your surgeon/physician has given you about prevention? — Sandra Z. (posted on August 17, 2007)
August 17, 2007
Hi Sandra. Do they say what keeps causing this???? I am familiar with the
Intussusception surgery as a friend of mine had it done. They did not put
in enough intestines and it came out and yes I heard it is painful. I wish
you all the best sweety!! Mickey..........
— MCraig3
August 18, 2007
This happened to me about 4 months after my RNY surgery. Anyone who has had
abdominable/bowel surgery has an increased probability of this happening. I
had major abdominable surgery in 1970 and had no such problem until last
November (2006). The same surgeon who did my laproscopic RNY procedure was
also in the O.R. for the emergency procedure to correct my intussusception.
He claimed that the location of the intussusception was well below where he
did his RNY work; therefore, his original surgery probably was not the
cause of the blockage. (Welcome to the world of fending off litigation.)
BTW, my pain was EXTREMELY ACUTE and I was permitted to remain in that
state in the E.R. for about 7 long hours before I was finally taken to the
O.R. for emergency surgery. I was informed at the end my my 4 day post
surgery stay in I.C.U. that I had experienced a "takotsubo" heart
attack (Japanese for 'octopus pot' ???; see
<http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy>) during the
surgery that was probably caused by the unabated pain that I was endured
prior to being taken from the E.R. to the O.R.. So, if you experience
another intussusception and its associated severe pain, INSIST that you be
given an IMMEDIATE and EFFECTIVE pain killer. I know I will. The bottom
line is that there is NOTHING that you can do to prevent the recurrence of
a bowel obstruction, now that you have had at least two major surgeries on
your bowel. Just be aware of what may be happening when you experience
abdominal pain and seek IMMEDIATE medical attention. Call 911 if necessary
because, as you stated, this is a LIFE THREATENING condition.
— [Deactivated Member]
August 18, 2007
Just a little added thing. Go to the top of one of the OH Web pages where
you will find a SEARCH box. Click on 'OH' above the box and type in
INTUSSUSEPTION, then click on the SEARCH button to the right. You'll then
get a list of plenty writeups from other OH members who have had this
problem.
— [Deactivated Member]
August 19, 2007
Hi, Sandra -
Sorry you're having to deal with this. I know exactly what you're dealing
with . . . I had RnY March 2003, intussuseption November '05, which wa
"reduced" (pulled apart) by a general surgeon. I saw my
bariatric surgeon a few weeks later, and he had a fit. He said "I
made you, you don't let anyone else cut your gut!" or something to
that effect.
So when it recurred in April '06, I insisted on being taken to him. He
resected (cut out) 20" of bowel, and moved the Y to make my common
channel the same length it had been. I have very distal bypass, so he
couldn't leave it 20" shorter.
I have not had any problems since.
MayoClinic.com says . . .
In adults, the cause of intussusception may be:
Noncancerous (benign) or cancerous (malignant) growths
Scar-like tissue in the intestine (adhesions)
Surgical scars in the small intestine or colon
Problems with the movement of food through the digestive tract (motility
disorders, such as irritable bowel syndrome, gastroparesis and
Hirschsprung's disease)
Long-term (chronic) diarrhea
So it's very possible that our problems are caused by a bit of scar or
adhesion.
*if* your problem does recurr - will your bariatric surgeon fix it? Maybe
you can check with him before you are screaming in pain?
I *don't* think it's likely to recurr, but I want you to feel safer. And
having a plan is always my best weapon.
I don't know about you, but my pain went from 0 to 10 in a couple of hours,
so having a plan before is best. Once you get the pain meds - no planning
is possible, huh?
Good luck, have faith, and don't worry - it doesn't help. :o)
— rayehawk
August 19, 2007
I would like to start by saying how sorry I am that you are going through
all of this. I too have had intususseption in my small bowel. I remember
the pain was so bad that I told the nurse if the next person that entered
my room wasn't bearing gifts (ie...good drugs :) she would have to
euthanize me.
I had my RNY in March 2003, all went well with my first surgery, no
complications..... but once I began eating solid foods, I vomitted non-stop
for the first 9 months and had about 5 scopes with balloon dilitation.
Finally...they realized that I was having a reaction to a surgical material
inside my body and they had to go in and remove it. I got better until
October 2005 when I developed a non-specific abdominal pain which was
finally diagnosed as a partial small bowel obstruction but was never
detected on films. Since I had my original surgery by an out of town Dr. I
found a local skilled WLS to perform my surgery. I wasn't strong enough to
handle surgery at first so they kept me on IV nutrition for about three
months in the hospital and then he finally removed adhesions and also made
my stoma larger because of scar tissue from my previous obstruction.
Wow...I got so much better....until 6 months later, out of nowhere I
developed intussusception at the anastamosis...turns out the opening that
the surgeon once made bigger to fix me was now too big and caused the
intussusception! I had emergency surgery and he removed about another foot
of my small bowel and somehow made two smaller stomas in place of one large
one so he fixed the intussussception but now I am having the exact same
problem that my Dr. fixed 2 years ago!!! UGh!! I now have a chronic
obstruction that never goes away...I look like I'm 8 months pregnant!!!
Although...I it's not so bad...I always wondered what it felt like to be
one of those "skinny pregnant people" :) Luckily; the abdominal
pain; though it can range in severity, it is more tolerable than an acute
intussusception; it basically come and goes like labor. I now have pain in
all of my joints, unexplained swelling, fevers, etc. and nobody knows
why...they aren't sure if it's from a coincidental disease like lupus or if
it's from my bowels, but I think it's a little too coincidental that this
joint pain started after surgery. I can't find anybody who wants to
operate on me because of my crazy medical history so for now it's hurry up
and wait and treat the symptoms as needed. I usually deal with the pain
the best I can until I can't take it anymore and I'll usually spend a week
or two out of every month in the hospital. My husband calls it my second
home!
I have to apologize....I was writing this to help YOU and I think I did the
exact opposite with my whining...I'm so sorry. I'm not all doom and
gloom..there are positives in this...I've lost 140 lbs...and kept it
off....and I know that my Dr.'s are doing the best they can to help me
while going through this diagnosis process.
Now, to FINALLY answer your question...It has been suggested to me to eat a
high fiber to help regulate BM's and if that doesn't work I take something
to help me go, but under my Dr.'s direction. I try to keep as active as I
can because exercise helps to stimulate my bowels...perhaps you could check
medications that could interefere with maintaining healthy bowel habits
because for me, if my bowels aren't flowing properly then they try to
overcompensate and can even possibly even cause an obstruction. I wish you
the best and please feel free to contact me privately through my e-mail if
you want to talk further. I promise I won't talk this much..:)
Denise L
— denisel
August 19, 2007
Thanks to everyone that has responded so far. I have been researching via
the web and have found little information about Intussusceptions in adults.
My surgeons have even told me how very rare it is even in people who have
had Gastric bypass surgery. However, I don't think it gets reported or
passed on to other surgeons just how many of us there actually is. I am
writing my surgeon and his team that performed my Gastric Bypass. Dr. James
Sapala is now in New York performing bariatric surgeries and also teaching.
The others are still here in Michigan with CORI centers. I am hoping word
gets around to warn patients of Intussusceptions.
— Sandra Z.
August 21, 2007
— Tigs
October 6, 2007
I just underwent surgury to correct an Intussusception 1.5 years after my
bypass it was the worst pain I have ever felt...
— lakabos
June 17, 2008
I'm hospitalized right now with intussussception. My RNY was in June 2001.
The doctors are trying other things to see if the intestines will
untangle, but who knows?
— PT LawMom
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