{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T11:22:54Z","timestamp":1787743374442,"version":"build-2784847793"},"reference-count":14,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intussusception of the Roux\u2010en\u2010Y limb after pediatric liver transplantation (LT) is an extremely rare but potentially life\u2010threatening complication. Altered anatomy, postoperative adhesions, and disrupted intestinal motility create a unique pathophysiological environment, which may delay diagnosis and increase morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed a patient with acute intestinal obstruction after living donor liver transplantation. Clinical presentation, laboratory findings, imaging results, intraoperative observations, surgical management, and outcomes were reviewed. The potential pathogenesis was explored in relation to factors such as Roux\u2010en\u2010Y reconstruction, graft\u2010to\u2010recipient size ratio, and postoperative adhesive disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The patient presented with fever and melena. Laboratory evaluation revealed leukocytosis and severe anemia. Computed tomography demonstrated small bowel intussusception with obstruction. Emergency laparotomy identified intussusception of the proximal Roux limb near the biliary\u2010enteric anastomosis. Manual reduction was unsuccessful, necessitating segmental resection without reconstruction of a new Roux limb. Extensive intra\u2010abdominal adhesions were noted. Postoperative recovery was uneventful, and graft function remained stable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intussusception of the Roux\u2010en\u2010Y limb following pediatric living donor liver transplantation is a complex surgical emergency. This case demonstrates that in the transplant population, symptoms such as fever and melena should trigger immediate cross\u2010sectional imaging to rule out mechanical obstruction. The management strategy must be aggressive yet conservative regarding anatomical disruption. As the population of long\u2010term pediatric transplant survivors grows, recognizing these distinct mechanistic patterns is essential for reducing morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70439","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T07:10:12Z","timestamp":1787555412000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Proximal Roux\u2010en\u2010Y Limb Intussusception After Pediatric Living Donor Liver Transplantation for Biliary Atresia: A Rare Surgical Emergency"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8685-0135","authenticated-orcid":false,"given":"Peng","family":"Cai","sequence":"first","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development  Tokyo Japan"},{"name":"Department of General Surgery Children's Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3031-7319","authenticated-orcid":false,"given":"Seisuke","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2441-5158","authenticated-orcid":false,"given":"Hajime","family":"Uchida","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1543-5838","authenticated-orcid":false,"given":"Chanokkamol","family":"Kiataramkul","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development  Tokyo Japan"},{"name":"Department of Surgery Queen Sirikit National Institute of Child Health  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayane","family":"Oshiro","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7783-0289","authenticated-orcid":false,"given":"Masato","family":"Kojima","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2547-4790","authenticated-orcid":false,"given":"Ryuji","family":"Komine","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3669-5548","authenticated-orcid":false,"given":"Yusuke","family":"Yanagi","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4684-0446","authenticated-orcid":false,"given":"Akinari","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1651-0430","authenticated-orcid":false,"given":"Mureo","family":"Kasahara","sequence":"additional","affiliation":[{"name":"Organ Transplantation Center, National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14123"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2010.09.017"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.17116\/hirurgia202211168"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2025.1624050"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20103046.2011.01532.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.24875\/CIRU.19000642"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.926089"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887\u2010023\u201003961\u2010y"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.60192"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000035396"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2013.601"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1290059"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1155\/2009\/579501"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/5625371"}],"container-title":["Pediatric 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