Intussusception - abdominal pain without fever or nausea

[twseid58 2]

About a month ago I started having abdominal pain. I thought it was another bout of diverticulitis. Years ago I was hospitalized for it and have had several recurrences. My GP put me in Cipro. The pain seemed to go away but came back before two weeks was up. I returned and he prescribed Cipro & Flagyl and ordered CT scans. He told me the scans came back suggesting I had a rare condition in adults called intussusception, which means the intestine telescopes on itself. At the time I had no idea it was related to my RNY gastic bypass surgery. I went to a local surgeon for a consultation. He didn't think the CT scans looked like intussusception, so he wanted me to have a small bowel pass through. I was still having abdominal pain, though he said people with this condition would be writhing in pain. That was a Friday; I had to wait until Wed. of the next week to have the procedure done. I met with him on Thursday. The results were normal and he suggested I return to my bariatric surgeon. That Friday the pain was almost gone. I met with the bariatric surgeon on Monday in Indianapolis and she had me do a CT scan with contrast that afternoon. At this point I hardly felt any problem in my abdomen. She talked with me briefly by phone at the hospital to say she thought it was not an internal hernia but intussusception. If the pain returned, I should contact them right away.

I'm wondering if anyone else has had this happen to them? I understand it is a complication with RNY surgery. My daughter said she saw a statistic that it happens in 1 of 1000 RNY patients.

I'm also not quite sure how much pain I should be in before contacting the surgeon. It's three days later and I can still feel something. Although the intestine can straighten itself out, it can still fold in on itself again. I'm not entirely confident that I've received the correct diagnosis; it seems like it's just based on a process of elimination: it's not an ulcer and not an internal hernia.

Edited March 19, 2015 by twseid58

[James Marusek 5,244]

Early symptoms of intussusception can include periodic abdominal pain, nausea, vomiting (sometimes bile stained [green color]), pulling legs to the chest area, and intermittent moderate to severe cramping abdominal pain. Pain is intermittent—not because the intussusception temporarily resolves, but because the intussuscepted bowel segment transiently stops contracting. Later signs include rectal bleeding, often with "red currant jelly" stool (stool mixed with blood and mucus), and lethargy. Physical examination may reveal a "sausage-shaped" mass, felt upon palpating the abdomen.

The condition is not usually immediately life-threatening. The intussusception can be treated with either a barium or water-soluble contrast enema or an air-contrast enema, which both confirms the diagnosis of intussusception, and in most cases successfully reduces it. The success rate is over 80%. Cases where it cannot be reduced by an enema or the intestine is damaged require surgical reduction.

[maceyjane 0]

I know this is an old post but in case someone comes here looking for information or experience. I had rny may of 2009. Dec of 2012 i was admitted to the hospital for what they thought was gallbladder issues. I was sent home eith nothing done. Pain was unbearable so i went to er two days later. I was admitted for emergency surgery after a ct scan was done. I had never heard of an intussusception, since its rare in adults. I was dying at home, and if surgery had not been done i would have been dead within two days. The pain i had was sudden, behind my sternum and came in very strong waves. I was unable to walk or breathe through the 30 to 40 min pain episodes. Please dont take something like this casually. You are the only one who truly knows your own body.

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[twseid58 2]

Let me give a follow-up to my situation. No evidence could be found in any tests that I was experiencing intussusception. Eventually, the only diagnosis that could be suggested was that there was some ulcers. The only basis for that was that I mentioned that I had gotten into the habit of drinking wine in the evenings. Altogether I had a highly acidic diet and had stopped taking Omeprazole. I stopped drinking alcohol, stopped eating a pot of chili a week, and started back on Omeprazole. A year later and I have not had any other symptoms. Over the past year I have become an avid cyclist and am in the best shape of my life.

As I think about it, I don't believe the pain I was experiencing was ulceration. But I needed to remove the likelihood of that diagnosis in order for them to be able to figure out what my problem might be. On the other hand, I don't think my pain was as severe as it should have been if I did have an intussusception. I don't know, so I intend to stick with my current way of life, which is greatly improved over where I was a year and a half ago. Still really, really glad I had the gastric bypass surgery. I'm working on losing some more with a goal of another 15 lbs. so I'll reach the 200 lbs. lost goal.

[JWeb2016 0]

I had gastric bypass surgery thirty years ago. In that time frame little was known about the long term outcome. At least where I lived there was. Without any education I manage to lose all the weight I needed to. Life was good, I was young, about to get married. I woke one morning about 4am with back pain. At 4am I did an exercise routine with the aid of television thinking I just was having muscle spasms. Before the half hour routine completed I knew there was something gravely wrong. I was on my knees and had crawled to my parents bedroom in unimaginable pain. Now in the ER and it 6am they discussed privately with my parents that I was having stress problems that was bringing on the pain and they was writing my release papers. Quickly after this time I began to vomit blood and our family physician just happen to be walking through the ER for morning rounds. The rest of the morning is sketchy for me. I remember swallowing a tube which pump my stomach. I remember being taken to an endoscopy. I remember multiple people holding me down as I fought them in excruciating pain. I remember begging my mother to have them put me to sleep and telling her calmly I knew I was dying. Then I remember waking in intensive care. The surgeon and my family explained that I had an intussusception and the surgeon (unfamiliar with bariatric surgery) had to cut a portion of my intestines out and put it back together. It has telescoped so tightly they died and I bled internally. In fact the endoscopy showed them nothing but blood so they had to go in with exploratory surgery to find the cause. Another hour I would have died. At the time this happen I was told the Dr's were not accustom to this happening to an adult and in fact it was so rare they had never seen it to even know to look for it. From this forum it seems knowledge has come a long way.

This is not something to take lightly. I had no warning signs what so ever. I had about eight hours from start to when they said I would of died for all events to unravel and take place. While I had great success with gastric bypass immediately I had major problems keeping the weight off. It took me fifteen years to seek out what happen that changed my bypass so greatly. After tests I was told the surgeon when putting my intestines back together made the empty of the stomach so large the food just falls through leaving my entire intestinal track to hold what a stomach would. While I am thankful the surgeon saved my life, I am sad that thirty years later I am disabled due to my weight and health. I am trying to seek a revision but in my case it is far more than a revision and while having two stomach surgeries each one greater than that last I will be facing the most serious one if I can get insurance to cover it.

Good luck to anyone that is facing this. If you even think it could be this don't hesitate it's a very serious situation.

[Krista143 20]

Thank you for sharing your knowledge about possible long term effects

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