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Ann Thorac Surg 2006;81:1134-1136
© 2006 The Society of Thoracic Surgeons

Case report

Retrograde Gastric Intussusception After Myotomy for Achalasia

Michael B. Ujiki, MD a , Ikuo Hirano, MD b , Matthew G. Blum, MD a , *

a Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
b Department of Gastroenterology, Northwestern University Feinberg School of Medicine, Chicago, Illinois

Accepted for publication February 9, 2005.

* Address correspondence to Dr Blum, Galter 10-105, 201 E Huron St, Chicago, IL 60611 (Email: mblum{at}nmh.org).

Retrograde gastroesophageal intussusception has been rarely reported in the literature. Risk factors include poor fixation of the stomach due to either long or loose mesenteric attachments; high intraabdominal pressure due to retching, physical exertion, or ascites; and hiatal hernia, which can lead to the development of a large gastroesophageal opening. An attempt at endoscopic reduction is reasonable, but laparotomy and manual reduction is usually required. We report a case of retrograde gastroesophageal intussusception in a patient with long-standing achalasia and two previous Heller myotomies.






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