Adult Intussusception: An Uncommon Condition and Challenging Management

Abstract

<b><i>Introduction:</i></b> Intussusception is a rare condition in adults. A pathological lesion is usually found with a significant percentage of malignancy. The optimal treatment is still not universally clear. <b><i>Methods:</i></b> This is a retrospective review of adult patients with a diagnosis of intestinal intussusception and surgically treated at our institution from January 2009 to December 2018. Clinical, operative, and histological details were collected and analyzed. <b><i>Results:</i></b> A total of 26 cases, 16 males and 10 females, were diagnosed with surgically proven intussusception during the 10-year period. The mean age was 45 years (range 21–70). Using ultrasound and/or computed tomography as imaging study, the preoperative diagnosis was made in 21/26 (81%) patients. Five intussusceptions were discovered only upon exploratory laparotomy for intestinal obstruction. There were 19 (73%) cases of enteric and 7 (27%) cases of colonic intussusceptions. All patients underwent surgical exploration. Intestinal resection with immediate anastomosis was the technique of choice for most patients. A single patient underwent stoma for peritonitis secondary to intestinal perforation. An organic cause has been systematically revealed, and no idiopathic intussusception was detected. Etiology was malignant in 9 (35%) cases. <b><i>Conclusion:</i></b> Adult intussusception should be considered in any patient with subacute abdominal pain. Considering the high rate of malignancy, intestinal resection without attempting reduction is highly recommended for colonic intussusceptions. However, a more selective approach can be adopted for enteric intussusceptions.

A Rare Case of Signet Ring Cell Colon Cancer Presenting as Adult Colorectal Intussusception

“…Adult onset intussusception accounts for 5% of all intussusceptions and 1% of cases of bowel obstruction. Most adult cases are colocolonic and up to 60% of these are caused by primary colonic adenocarcinoma [ 5 , 6 ]. Signet ring cell colon carcinoma, like its more common gastric counterpart, usually presents as a diffuse infiltration of the bowel and was originally described by Laufman and Saphir as a linitus-type carcinoma of the colon [ 7 ].…”

Traitement Laparoscopique Dun Cas Rare Dune Invagination Intestinale Aigue Sur Lipome Grelique

“…Elle survient le plus souvent chez l'enfant, En revanche, elle est rare chez l'adulte et survient seulement dans 5% de toutes les occlusions. Les tumeurs de l'intestin grêle ne représentent que 1% à 2% de toutes les tumeurs du tractus digestif et les tumeurs bénignes représentent environ 30% de toutes les tumeurs de l'intestin grêle [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Le lipome intestinal, qui trouve souvent son origine dans l'iléon, est une tumeur bénigne d'origine mésenchymateuse, elle est la deuxième tumeur bénigne la plus fréquente de l'intestin grêle avec une tendance à l'invagination [1][2][3][4] en raison de la bonne mobilité de la tumeur, sa localisation dans la couche sous muqueuse et le péristaltisme actif de l'intestin grêle [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”

“…Quel que soit le tableau clinique initial, l'endoscopie, le lavement baryté, l'échographie abdominale et la TDM sont utiles pour déterminer le diagnostic d'invagination et pour identifier une éventuelle tumeur intestinale comme sa cause [14][15][16][17][18][19][20][21][22]. Plus rarement, le diagnostic est retenu par la chirurgie exploratrice.…”

“…En cas de lipome, il met en évidence une masse intraluminale de densité graisseuse au centre enveloppée d'une paroi digestive. Les deux images classiques sur le scanner sont l'image « en sandwich » en coupe longitudinale montrant la tête de l'IIA et l'image « en cocarde » en coupe transversale mettant en évidence le boudin de l'IIA [14][15][16][17][18][19][20]. Dans notre cas, le scanner a été d'un grand apport, il a révélé le boudin d'invagination sous forme de l'image typique en cocard.…”

Jejunojejunal intussusception with chronic bleeding caused by gastrointestinal stromal tumor: a case report and literature review

“…Intussusception rarely occurs in adults, with an annual incidence of approximately 2-3 per million people (1,2). Unlike pediatric intussusception cases, 90% of which are idiopathic, most adult intussusception cases are secondary to benign or malignant neoplasms such as gastrointestinal stromal tumors (GISTs) (1).…”