Intussusception in adults: a retrospective study

• Published in: Colorectal disease 2010-06, Vol.12 (6), p.574-578
• Main Authors: Hanan, B., Diniz, T. R., Da Luz, M. M. P., Da Conceição, S. A., Da Silva, R. G., Lacerda-Filho, A.
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Aged; Colonic Diseases - diagnosis; Colonic Diseases - surgery; Colonoscopy; Colorectal Neoplasms - complications; computerized tomography; Female; Humans; Ileal Diseases - diagnosis; Ileal Diseases - surgery; ileocaecal valve; Ileocecal Valve - pathology; Intestinal intussusception; intestinal obstruction; Intussusception - diagnosis; Intussusception - etiology; Intussusception - surgery; Male; malignant neoplasm; Middle Aged; Postoperative Complications; Retrospective Studies; ultrasonography; Young Adult
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/j.1463-1318.2009.01865.x

Objective  Intestinal intussusception in adult patients is rare. In contrast with paediatric patients, it is usually secondary to a definable lesion, often malignant. The purpose of this study was to determine the causes and the management of intussusception in adult patients. Method  A retrospective review was performed looking at patients over 18 years with intestinal intussusception who were admitted to a tertiary university hospital from 1997 to 2007. Result  There were 16 patients (out of whom 10 were female subjects) of mean age 49 years (range 19–76). All presented with abdominal pain and in seven (46.6%) patients, this was acute. The diagnosis of intussusception was correctly made preoperatively in eight (50%) patients. Six (37.5%) patients had the lead point for the intussusception at the ileocaecal valve, five (31.25%) in the small bowel and five (31.25%) had a colonic lead point. An anatomical cause was found in 14 (87.5%). In two (12.5%), the intussusception occurred in the postoperative period without any definable lesion. Half the patients had a malignant neoplasm. All patients underwent surgery. In 14 (87.5%) patients, this was by resection and in two (12.5%), a reduction with no resection was carried out. Conclusion  The features of intussusception may be nonspecific and the diagnosis is often made only during laparotomy. An identifiable organic lesion is present in most cases. En bloc resection is recommended for ileocaecal and colocolic intussusception.