Intussusception in Adults: A 21-Year Experience in the University-Affiliated Emergency Center and Indication for Nonoperative Reduction

Abstract

Background: While intussusception is relatively common in children, it is rare in adults. Methods: We retrospectively reviewed the records of all patients older than 18 years with the diagnosis of intussusception between 1981 and 2001. Results: Eleven patients with surgically or endoscopically proven intussusception were encountered at the University-affiliated emergency center. The patients ranged in age from 19 to 88 years with a mean age of 45 years. Males predominated by a ratio of 7:4. Most patients (82%) presented with symptoms of bowel obstruction. The mean duration of symptoms was 4.5 days with a range of 4 h to 25 days. Correct pre-treatment diagnosis was made in 82% of the patients using abdominal ultrasonography and computed tomography (CT). The causes of intussusception were organic lesions in 64% of the patients, postoperative in 18% and idiopathic in 18%, respectively. 73% of patients had emergency operations, and an attempt at nonoperative reduction was performed and completed successfully in 3 patients with ileo-colic or colonic type of intussusception. There have been no cases of morbidity or mortality in our series and no recurrence has occurred up to the present time. Conclusions: Abdominal ultrasonography and CT were effective tools for the diagnosis of intussusception. Patients with ileo-colic and colonic intussusception without malignant lesions could be good candidates for nonoperative reduction prior to definitive surgery.

Is non-operative intussusception reduction effective in older children? Ten-year experience in a university affiliated medical center

“…Five patients had follow-up imaging as inpatients after the successful reduction, including UGI series [1], US [4] and abdominal CT [3], to exclude additional pathology or a lead point that could be missed by fluoroscopy. All these examinations were within normal limits.…”

“…The medical literature also states, that any child older than 6 years with colic abdominal pain, palpable abdominal mass and radiological evidence of intussusception should be considered as having an ileal lymphosarcoma, until proved otherwise [11,12]. Partially due to this data, and partially due to the reports that adult intussusception is caused by malignant lead points in more than 50% of the cases [3][4][5], in many hospitals, especially non-pediatric, surgeons tend to operate on older children with intussusception, without attempt of imaging-guided reduction. Some preexisting conditions including cystic fibrosis, Henoch-Shonlein purpura, Peutz-Jegers polyposis and juvenile polyposis, are well known to be associated with childhood intussusception.…”

“…In the adult population intussuscepton is uncommon, and very rarely idiopathic. In about 50% of adult cases it caused by a malignant lead point [3][4][5]. Therefore, when an older child presents with a clinical picture of intussusception, especially in non-pediatric hospitals, surgery is often performed without an attempt at radiologically guided reduction.…”

À propos d’un cas d’invagination intestinale chez un patient porteur d’une maladie de Crohn méconnue

“…Les invaginations colocoliques ne représentent que 27 % des cas. Les invaginations distales coloanales ou colorectales (2,1 à 9,4 %) ou jéjunogastriques sont plus rares [11][12][13].…”

Finite Element Analysis Of Mechanical Behaviour Of Dental Materials

“…Abdominal computerized tomography (CT) is the most useful imaging method for the diagnosis of intussusception followed by ultrasound scan which is considered the second most effective imaging tool 7,8 .…”