Two Unusual Cases of Adult Intussusception

Bellows, Charles F.; Haque, Salima; Jaffe, Bernard M.

doi:10.1159/000064220

Cited by 7 publications

(3 citation statements)

References 18 publications

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“…Meckel's diverticulum [4], inflammation in HIV-positive patients [14], malabsorption syndromes [15], and gastrointestinal infections have all been associated with intussusception. Intussusception has also been related with severe hyperglycemia [16] and acute appendicitis in young adults [17] and has been reported in pregnancy [18]. Increasing evidence also suggests an association with a roux-en-Y bypass in gastric bypass patients [19,20].…”

Section: Discussionmentioning

confidence: 99%

Adult intussusception: a single-center 10-year experience

et al. 2013

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SummaryBackground Adult intussusception (AI) is a rare condition, usually with a lead point, and for which surgery is the treatment of choice. Given the risks and possible complications of untreated AI, an accurate preoperative diagnosis is of the utmost importance. Although AI remains difficult to diagnose, computerized tomography (CT) is presently considered the best diagnostic tool.Methods Sixteen patients of 20 years and older with intraoperative diagnosis of intussusception, who underwent surgery between January 2000 and December 2009, were reviewed retrospectively. Patients were assessed concerning clinical presentation, imagiological findings, surgical treatment, and postoperative histological evaluation.Results Most patients (93.8 %) were admitted via emergency room (ER) due to abdominal pain. Fourteen (87.5 %) AI cases showed an underlying organic cause, e.g., masses or tumors. The most frequent comorbidities were Peutz-Jeghers syndrome (PJS; 18.8 %) and HIV (12.5 %). Eight (50.0 %) intussusceptions were ileocolic and six (37.5 %) were in the small bowel. Total 43.8 % of lesions were malignant. Preoperative diagnosis of intussusception was possible in 50.0 % of cases by ultrasonography (US) and in 81.8 % by CT. US showed no predictive value concerning intussusception location. Total 27.3 % of CTs correctly identified the location, but only 9 % accurately identified the lead point.Conclusions We propose that all AI cases should be treated with surgical resection without attempting reduction, even when no lead point is detected by imaging studies, and this approach should be based on the oncological criteria. CT can be regarded as the most accurate diagnostic tool for intussusception, although its predictive value concerning location and lead point is still far from ideal.

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Section: Discussionmentioning

confidence: 99%

Adult intussusception: a single-center 10-year experience

et al. 2013

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“…3,4,5,9 In the colon, strict adherence to resection without manipulation or reduction is advocated owing to the high association of malignant pathology. 9,10 …”

Section: Discussionmentioning

confidence: 99%

Post Colonoscopy Colonic Intussusception Reduced via a Laparoscopic Approach

Ho¹,

Park²,

Prasad³

2010

JSLS

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“…In the colon, this is most likely to be a primary adenocarcinoma, but in small bowel lesions, metastatic disease, such as melanoma, is more common (2,8). Benign causes include Meckel's diverticulum, lipomas, polyps and hyperplasia of lymphoid tissue, but there are numerous reports of rare causes of the condition in the literature including intussusception secondary to acute appendicitis in the young adult (9).…”

Section: Discussionmentioning

confidence: 99%