Small bowel intussusception in adults

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Abstract

Intussusception is the telescoping of a proximal segment of the gastrointestinal tract into an adjacent distal segment. This rare form of bowel obstruction occurs infrequently in adults. We report a case of small bowel intussusception in an adult male patient. We have also performed a literature review of this rare condition.

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Most cited references 19

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The diagnosis and management of adult intussusception.

A. Sandor, D. Begos, I Modlin (1997)

While intussusception is relatively common in children, it is a rare clinical entity in adults, where the condition is almost always secondary to a definable lesion. Thirteen cases of intussusception occurring in individuals older than 16 were encountered at our institute between 1981 and 1994. Presenting signs/symptoms included recurrent bowel obstruction, intermittent pain, and red blood per rectum. Correct preoperative diagnosis was made in six patients using colonoscopy, flexible sigmoidoscopy, upper gastrointestinal (GI) series and computed tomography (CT). At surgery the lead point was identified in the small intestine in eight cases, in the colon in four cases, and one small intestinal intussusception was considered idiopathic. Twelve patients underwent laparotomy and one patient was both diagnosed and treated by colonoscopy alone. Adult intussusception is an unusual cause of bowel obstruction. The likelihood of neoplasia, particularly in the colon as a cause, is high. Operative management is thus almost always necessary.

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Intussusception in adults: institutional review.

A. H. Aufses, Thomas D. Cunningham, Jane L Eisen (1999)

Intestinal intussusception in the adult is a rare entity that differs greatly in etiology from its pediatric counterpart. Controversy remains regarding the optimal management of this problem in the adult patient. The purpose of this study was to determine the cause(s) of intussusception and to determine the role of intestinal reduction in the management of intussusception in adults. A retrospective review performed at The Mount Sinai Medical Center identified 27 patients, 16 years and older, with a diagnosis of intestinal intussusception. Data related to presentation, diagnosis, treatment, and pathology were analyzed. There were 13 males and 14 females. The median age of the group was 52 years with a range of 16 to 90 years. Abdominal pain was the most common presenting complaint. A preoperative diagnosis was suspected in 11 of 27 patients (40%). There were 22 small bowel lesions and 5 colonic lesions. A pathologic cause was identified in 85% of patients with 8 of 22 (36%) small bowel and 4 of 5 (80%) of large bowel lesions being malignant. All small bowel cancers represented metastatic disease and all large bowel malignancies were primary adenocarcinomas. The median age of patients with malignant disease was 60 years; it was 44 years for those with benign disease. Operative treatment consisted of resection alone in 58% of patients and resection after reduction in 42%. Three patients were treated nonoperatively. Our data support a selective approach to the operative treatment of intussusception in adults. Colonic lesions should not be reduced before resection because they most likely represent a primary adenocarcinoma. Small bowel intussusception should be reduced only in patients in whom a benign diagnosis has been made preoperatively or in patients in whom resection may result in short gut syndrome.

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Adult intussusception: case reports and review of literature.

S Yalamarthi, Derek Smith (2005)

Adult intussusception occurs infrequently and differs from childhood intussusception in its presentation, aetiology, and treatment. Diagnosis can be delayed because of its longstanding, intermittent, and non-specific symptoms and most cases are diagnosed at emergency laparotomy. With more frequent use of computed tomography in the evaluation of patients with abdominal pain, the condition can be diagnosed more reliably. Treatment entails simple bowel resection in most cases. Reduction of the intussusception before resection is controversial, but there is a shift against this, especially in colonic cases. Surgical treatment can be difficult in gastroduodenal and coloanal intussusceptions, sometimes requiring innovative techniques. This paper presents the diagnosis and management of four cases of adult intussusception, followed by review of the literature.

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Author and article information

Contributors

A Al Samaraee

Journal

Journal ID (nlm-ta): Ann R Coll Surg Engl

Journal ID (iso-abbrev): Ann R Coll Surg Engl

Journal ID (publisher-id): ann

Title: Annals of The Royal College of Surgeons of England

Publisher: Royal College of Surgeons

ISSN (Print): 0035-8843

ISSN (Electronic): 1478-7083

Publication date (Print): January 2014

Publication date (Electronic): January 2014

Publication date PMC-release: January 2014

Volume: 96

Issue: 1

Pages: 11-14

Affiliations

South Tyneside NHS Foundation Trust,UK

Author notes

Department of General Surgery, South Tyneside District Hospital, Harton Lane, South Shields, Tyne and Wear NE34 0PL,UK E: ahmadas@ 123456doctors.org.uk

Article

Publisher ID: 650579

DOI: 10.1308/003588414X13824511650579

PMC ID: 5137662

PubMed ID: 24417823

SO-VID: ac4c5881-961f-490d-ba50-d8416ee1c821

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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Small bowel intussusception in adults

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Most cited references 19

The diagnosis and management of adult intussusception.

Intussusception in adults: institutional review.

Adult intussusception: case reports and review of literature.

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