Management of Adult Intussusception—A Case Series Experience from a Tertiary Center

Abstract

Background The management of intussusception is controversial. Clinical presentation, with the aid of imaging modalities, enables a better selection of patients for the appropriate treatment algorithm. Conservative management versus surgical intervention with bowel resection is considered accordingly. Methods Retrospective review of a computerized database of patients who were admitted with intussusception between January 1, 2010, and December 31, 2020, in a single tertiary center in Israel. Patients who were treated conservatively were compared to those who underwent surgery. Patients who underwent bowel resection were compared to those that had surgery without a resection. Results A total of 76 patients were diagnosed with intussusception, and 49 were operated. Bowel resection was performed in 32 cases. 20/76(26%) were successfully managed conservatively. Patients with a lead point (OR = 5.59) and colonic involvement (OR = 13.72) had a higher likelihood for resection. The likelihood of bowel resection was found to be significantly lower with proximal small bowel intussusception (OR = 0.071). Conclusion Young patients presenting with intussusception may be treated conservatively when adequate criteria are met in order to avoid unnecessary surgical interventions.

Incarcerated Prolapsed Sigmoid Intussusception Presenting as Rectal Prolapse Without a Lead Point

“…Most reports state that 70%–90% of cases have an identifiable source, a lead point, with 40%–50% being due to a malignancy and only 10% being idiopathic 4. There are published case reports discussing sigmoid intussuception through the rectum due to lipoma or malignancy 5–13. Our case report adds to the current literature by reporting on two cases that were idiopathic in nature without lead point/malignancy.…”

Jejunal intussusception and perforation due to enteric muco-submucosal elongated polyp: a case report and literature review

“…In contrast to that in children, intussusception in adults is relatively rare and commonly occurs with a pathological leading point [ 12 ]. Regarding the treatment of adult intussusception, whereas the conventional treatment of choice was surgical resection, recent studies showed good outcomes for conservative treatment [ 13 ]. On the other hand, we need to consider surgical intervention especially in cases of acute abdominal pain [ 12 ].…”

Burkitt Lymphoma Presenting as Ileocolic Intussusception in an Adult

“…Except for this patient’s case, all other instances of intussusception included in this cohort required either surgical resection (80%) or reduction (13%). A prior case series of adult intussusception from any cause reported a spontaneous resolution in 6 of 21 (29%) cases, though it is not clear how many of those cases were secondary to malignant lead points [ 40 ]. No patient with BL received upfront systemic chemotherapy as the primary means for addressing the intussusception.…”