Community teaching hospital surgical experience with adult intussusception: Study of nine cases and literature review

Abstract

HighlightsSurgeons should approach the acute abdomen with a broad differential.CT is a valuable diagnostic tool in the evaluation of adult intussusception.Laparoscopy is a useful adjunct for diagnosis and treatment of intussusception.There is a limited role of reduction prior to resection in very select cases.

Use of Ultrasound in the Diagnostic Work-Up of Adult Intussusception – A Multicenter Retrospective Analysis

“…Characteristic sonographic findings (▶ Fig. 6 and ▶ Video 3) are the "target or donut sign" on the transverse view and the "pseudo-kidney or pitchfork sign" on longitudinal views [1,6,15,17,24]. Although US is also useful in adults, CT is regarded as the gold standard by most authors with a sensitivity of 58 -100 % [2,3,11,12,16,25].…”

“…Furthermore, surgery can be avoided in selected patients with mild symptoms and diffusely metastasized malignancy after ruling out complications like ileus and intestinal infarction (case 14). Surgical reduction with/without resection can be performed in patients with enteric intussusception and benign lead points [1,2,12,15]. This is OP-VIDEO ▶ Video 1 Intussusception due to an inflammatory fibroid polyp in the terminal ileum.…”

“…Historically, surgical exploration has been regarded as inevitable in patients with AI due to associated malignancy in 19 -65 % of cases [3,10]. More recent studies, however, suggest that conservative management or surgical reduction of AI may suffice in selected patients (enteric intussusception without lead point and without bowel obstruction) [2,6,12,15]. Thus, a thorough diagnostic work-up is essential to diagnose the extent and location of intussusception, the presence/absence of a lead point and the presence/absence of complications like ileus, ascites and bowel wall infarction [5,6,11,16].…”

Adult ileocolic intususception: a case report

“…The average age of affected adults is between 50 and 60 years old and it occurs more often in women. 2,5 Colonoscopy contributes to diagnosis given that it provides direct visualization and biopsy. The reported presented with ileo-colic intussusceptions though ileo-ileal intussusceptions are more common than ileo-colic intussusceptions.…”

“…The higher percentage of intussusception in adults (65%) occurs due to malignant or benign neoplasms. 1,2 Intestinal adhesions post abdominal surgery is also leading cause of intussusceptions in adults. The average age of affected adults is between 50 and 60 years old and it occurs more often in women.…”