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      Adult intussusception: a retrospective review of 41 cases.

      World journal of gastroenterology : WJG
      Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Intussusception, diagnosis, etiology, pathology, surgery, Male, Middle Aged, Retrospective Studies, Young Adult

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          Abstract

          To optimize the preoperative diagnosis and surgical management of adult intussusception (AI). A retrospective review of the clinical features, diagnosis, management and pathology 41 adult patients with postoperative diagnoses of intussusception was conducted. Forty-one patients with 44 intussusceptions were operated on, 24.4% had acute symptoms, 24.4% had subacute symptoms, and 51.2% had chronic symptoms. 70.7% of the patients presented with intestinal obstruction. There were 20 enteric, 15 ileocolic, eight colocolonic and one sigmoidorectal intussusceptions. 65.9% of intussusceptions were diagnosed preoperatively using a computed tomography (CT) scan (90.5% accurate) and ultrasonography (60.0% accurate, rising to 91.7% for patients who had a palpable abdominal mass). Coloscopy located the occupying lesions of the lead point of ileocolic, colocolonic and sigmoidorectal intussusceptions. Four intussusceptions in three patients were simply reduced. Twenty-one patients underwent resection after primary reduction. There was no mortality and anastomosis leakage perioperatively. Except for one patient with multiple small bowel adenomas, which recurred 5 mo after surgery, no patients were recurrent within 6 mo. Pathologically, 54.5% of the intussusceptions had a tumor, of which 27.3% were malignant. 9.1% comprised nontumorous polyps. Four intussusceptions had a gastrojejunostomy with intestinal intubation, and four intussusceptions had no organic lesion. CT is the most effective and accurate diagnostic technique. Colonoscopy can detect most lead point lesions of non-enteric intussusceptions. Intestinal intubation should be avoided.

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          Author and article information

          Journal
          19598308
          2710788
          10.3748/wjg.15.3303

          Chemistry
          Adolescent,Adult,Aged,Aged, 80 and over,Female,Humans,Intussusception,diagnosis,etiology,pathology,surgery,Male,Middle Aged,Retrospective Studies,Young Adult

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