PMC8289613_01
Esophagogastroduodenoscopy performed 20 hours after the patient's last meal revealed significant food residue in the esophagus and stomach, suggesting possible bowel obstruction.
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Esophagogastroduodenoscopy (EGD) performed 20 hours after the patient's last meal revealed a mildly distended stomach with significant food residue in the esophagus and stomach (Figure 1).
(a) Computed tomography (CT) without contract was largely unremarkable, with no visible signs of tumor or bowel obstruction in the jejunum (arrow). (b) CT with contract taken several minutes later revealed a bowel-in-bowel configuration with invaginated mesentery, consistent with jejunojejunal intussusception (arrow). No mass was visualized.
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CT without contract was largely unremarkable, with no visible signs of tumor or bowel obstruction (Figure 2(a)). However, CT with contrast taken several minutes later revealed the "target sign," a bowel-in-bowel configuration measuring 7 cm in the proximal jejunum with invaginated mesentery (Figure 2(b)).
(a) Adhesions from previous laparoscopic oophorectomy observed near a port placed in the right lower quadrant (arrows). (b) The surgeons used laparoscopic grasping forceps to apply gentle pressure to the stomach to facilitate scope insertion during intraoperative peroral jejunoscopy. (c) When the endoscope reached the jejunum, the laparoscopic camera was pointed distal to the suspected location of the reduced intussusception to signal the desired destination for endoscopic viewing. Forceps were also gently placed at this location to facilitate insufflation.
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Adhesions from previous laparoscopic oophorectomy were observed near a port placed in the right lower quadrant (Figure 3(a)). The surgeons used laparoscopic grasping forceps to apply gentle pressure to the stomach to facilitate scope insertion (Figure 3(b)). Forceps were also gently placed at this location to facilitate insufflation (Figure 3(c)).
Light from the laparoscopic camera showing through the jejunal wall confirmed passage of the endoscope beyond the site of intussusception.
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The endoscope was inserted until light from the laparoscopic camera was visualized, confirming the absence of tumors or other lesions which may serve as a lead point for intussusception (Figure 4).