Intussusception – A common entity but seldom diagnosed (lesson learnt from case series for family physicians)

Abstract

Intussusception is one of the common causes of acute abdomen in paediatric age bracket with ileocolic type being the most prevalent. This happens when a proximal segment of bowel (intussusceptum) telescopes into the lumen of the adjacent distal segment (intussuscepiens). Here we report six cases of intussusception in which five were in paediatric age group and one was adult. All children were admitted, resuscitated well, USG abdomen was done to confirm the diagnosis, written and informed consent for surgery and anaesthesia, was taken from parents. However, all were managed successfully by hydrostatic saline reduction under sedation. Only one child had recurrence after one year who was again treated conservatively. Adult case was managed by means of laparotomy by excision of benign polyp being the pathological lead point. We present this case series to analyse the spectrum of presentation, diagnostic and therapeutic options available with review of literature. Since primary care providers and family physicians are first responders, this case series would help them for differential diagnosis and prompt referrals for further management.

Intussusception in an adult revealing a Vanek's tumor: A case report

“…They can affect any part of the gastrointestinal tract. The most common site is the gastric antrum (66 %–75 %), followed by the small bowel (18 %–20 %), colorectal region (4 %–7 %), gallbladder (1 %), esophagus (1 %), duodenum (1 %), and appendix (<1 %) [5] , [6] . The etiology of IFPs is unknown and many theories were suggested [1] , [7] .…”

Ileocolic Intussusception in an Adult Due to Inflammatory Fibroid Polyp: A Case Report

“…The most common site of IFP is the gastric antrum (70%) followed by the small bowel (20%) [ 1 , 7 , 12 ]. The rare sites of IFP are the rectum, duodenum, and esophagus (the distal third being the commonest site) [ 12 , 13 ].…”

“…Radiological diagnosis of intussusception is often made by ultrasound especially in the pediatric population [ 1 , 3 ]. In adults, the diagnosis is made by CECT or MRI [ 2 , 4 , 5 ].…”

“…Intussusception is common in children but rare in adults [ 1 , 2 ]. The main cause of intussusception in children is idiopathic and responds to conservative treatment in most cases.…”

“…It often causes acute or chronic intermittent bowel obstruction [ 3 ]. Preoperative diagnosis is often missed or delayed due to non-specific symptoms [ 1 ]. Abdominal imaging can help in making a timely diagnosis of intussusception but the lead point may not be visible [ 5 ].…”