Factors predicting malignancy in adult intussusception: An experience in university-affiliated hospitals

• Published in: Asian journal of surgery 2018-01, Vol.41 (1), p.92-97
• Main Authors: Kim, Jong Wan, Lee, Bong Hwa, Park, Sung Gil, Kim, Byung Chun, Lee, Samuel, Lee, Sang-Jeon
• Format: Article
• Language: English
• Subjects: adult; intussusception; malignancy; Surgery
• ISSN: 1015-9584
• DOI: 10.1016/j.asjsur.2016.11.010

Summary Background Intussusception is one of the common causes of intestinal obstruction in children but is uncommon in adults. Unlike pediatric intussusception, most adult cases have a demonstrable etiology. The purpose of this study was to review our experience of adult intussusception and to identify the predictive factors for malignancy in this disease. Methods We retrospectively reviewed the medical records of patients who were diagnosed with intussusception and admitted to the six Hallym University-affiliated hospitals between January 2005 and July 2016. Results The 77 patients had a mean age of 50.5 years (range, 18–91 years). Enteric intussusception is the most common type of adult intussusception (33.7%), and 11 patients (14.2%) had no definite lesion at operation. The most common symptom was abdominal pain (90.9%), and 18 (23.3%) presented with chronic symptoms. Computed tomography was the most common diagnostic modality used, with a diagnostic accuracy of 96.9%. The leading point was identified in 62 (80.5%) patients. Malignancy was more frequently present in the colonic type than in the other two types (61.5% vs. 10%, 37.9%). In a multivariate analysis, chronic symptom >14 days ( p  = 0.031) and colonic intussusception ( p  = 0.026) were independent predictors for malignancy. Conclusions Enteric intussusception is the most common type of adult intussusception, and the most common test is computed tomography. Because chronic symptoms and colonic-type intussusception were predictive factors for malignancy, en bloc resection should be considered in patients with chronic or colonic intussusception.