Adult intussusception: An 8 years institutional review

Abstract

Background:Intussusception is a rare cause of intestinal obstruction in adults. Its diagnosis could be elusive based solely on clinical features because of protean presentation. Supplementary imaging allows for preoperative diagnosis, early institution of definitive management, and a better clinical outcome.Patients and Methods:Records of adults managed for intestinal obstruction by laparotomy in a surgical unit of a tertiary health facility were retrospectively examined. The subgroup having an intraoperative diagnosis of intussusception was extracted and analyzed. Data obtained included age, sex, and primary symptom at presentation. Presence of intestinal perforation, the histology of the lead point of resected tissues, and the final disposition of the patients were documented.Results:Four hundred and three patients underwent surgical management of intestinal obstruction. Eight patients (2%) had an intraoperative diagnosis of intussusception at laparotomy; four males and four females (male: female = 1:1). Abdominal pain was the presentation in 7 (87.5%) and anal protrusion in 1 (12.5%). Four patients (50%) had bowel perforation with peritonitis. Seven of the resected intestines had lead points which were benign. Two patients (25%) died from sepsis. Resection and anastomosis were done for all the patients.Conclusion:Intussusception in adults is uncommon but carries a high morbidity and mortality which can be reduced with a good clinical assessment, appropriate imaging, and early laparotomy.

Ileal lipoma: a rare lead point for adult ileocolic intussusception

“…Although it is a common cause of intestinal Case report obstruction in children, it is rare in adults. Adult intussusception represents 5% of all cases of intussusception and accounts for only 1-5% of intestinal obstructions in adults (1,3). In contrast to intussusception occurring in children, adult intussusceptions have a pathologic lead point in up to 90% of cases (4).…”

“…Clinically, it is often misdiagnosed in adults and taken for more common causes of acute abdomen such as appendiceal pathology, gastrointestinal malignancy, and enteritis (1). Adult intussusception represents 5% of all cases of intussusception and accounts for 1-5% of intestinal obstructions in adults (2,3). In contrast to intussusception occurring in children, adult intussusceptions have a pathologic lead point in up to 90% of cases (4).…”

Ileoileal intussusception caused by the metastasis of cutaneous malignant melanoma to the small bowel 6 years after its excision presenting with small bowel obstruction

“…with interest, for what I would like to thank the authors. 1 I would like to share an extremely rare and interesting case from our practice.…”

Intususcepción de muñón ileal, reporte de caso y revisión de la literatura

“…El síntoma más frecuentemente reportado en la mayor parte de las series es el dolor abdominal, en entre el 70 y el 90% de los pacientes. En aquel que no se presenta como una urgencia quirúrgica el dolor es de tipo intermitente y el tiempo promedio de aparición de síntomas es de 37.4 días 1, [3][4][5][6][7] .…”

“…El estudio de imagen más útil para diagnóstico es la tomografía 2,4 , es importante mencionar que el diagnóstico, en no más del 30.7% de los casos se logra realizar antes del evento quirúrgico 8 . El tratamiento en adultos es la resección quirúrgica sin reducción, esta misma podría ser aceptable en intususcepciones traumáticas, idiopáticas o sin causa patológica intestinal 1,4,5 .…”