A Clinical Review of the Intussusception in Adult

Kim, Su Jin; Park, Cheol Hee; Kim, Yong Min; Kim, Seong Yeol; Chun, Seung Yeon; Kwon, Chin Woo; Park, Ji Won; Kim, Kyoung Oh; Baek, Il Hyun; Yoo, Kyo Sang; Kim, Jong Hyeok; Park, Choong Kee

Abstract

BACKGROUND/AIMS
Intussusception is uncommon in adults compared with children. The present study aimed to review our experience of adult intussusceptions and discuss the preoperative diagnosis and management.
METHODS
A retrospective review was performed for 25 patients, at least 18 years old. These patients were diagnosed as intestinal intussusceptions at Hallym University Sacred Heart Hospital from January 1999 to October 2010.
RESULTS
There were 14 male and 11 female with a mean age of 55 years. The most common symptom was abdominal pain. The preoperative diagnostic rate was 92% because of the use of an abdominal computed tomography (CT) and an ultrasound. A total of 9 (36%) patients had enteroenteric intussusception, 8 had ileocolic, 1 had ileocecal and 7 patients had colocolic intussusception. A discrete pathologic process was present in 22 (88%) patients and the remaining 3 (12%) patients were idiopathic. There were 12 small bowel lesions and 10 colonic lesions. Neoplasms were the most common etiology of intussusceptions. Of the cases with a defined colonic cause, 8 (80%) were malignant. Overall, 12 (48%) patients underwent primary resection of the intussusception without prior reduction, 11 (44%) patients had reduction of their intussusception followed by resection.
CONCLUSIONS
Adult colonic intussusception is usually associated with malignancy. All patients with obstruction of unknown cause or lead point on CT should consider surgical exploration.