Adult Intussusception in the Last 25 Years of Modern Imaging: Is Surgery Still Indicated?

Onkendi, Edwin; Grotz, Travis E.; Murray, Joseph A.; Donohue, John H.

doi:10.1007/s11605-011-1609-4

Cited by 72 publications

(104 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…7 CT has a sensitivity of 58-100% and a specificity of 57-71% in determining the etiology; a "target sign" or a "sausage shaped" mass with different layers of attenuation can be shown in CT. 2,6 US is easy to perform and non-invasive, especially useful in children. Classic features like "target", "donut" signs or pseudokidney can be revealed on US but image interpretation can be difficult in presence of air.…”

Section: Discussionmentioning

confidence: 99%

“…1 This condition is uncommon in adults, with two to three cases occurring in a population of 10,00,000 per annum and accounts for less than 0.1% of all adult hospital admissions. [2][3][4] The diagnosis in adults is usually made at laparotomy, as most patients present as an emergency with intestinal obstruction. In non-emergency patients the diagnosis can be challenging as symptoms include intermittent abdominal pain that often settles comparatively quickly.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ileo-ileal intussusception due to lipomatous growth

Bijwe

Najan²,

Hake

2016

Int J Res Med Sci

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ileo-ileal intussusception due to lipomatous growth

Bijwe

Najan²,

Hake

2016

Int J Res Med Sci

View full text Add to dashboard Cite

“…The clinical presentation in adult is often nonspecific, making diagnosis a challenge. Most commonly, patients present with abdominal pain [1][2][3]. The less common presentations include complete or partial bowel obstruction, heme-positive stools, a palpable mass and incidental finding on imaging [1,2].…”

Section: Discussionmentioning

confidence: 99%

“…Most commonly, patients present with abdominal pain [1][2][3]. The less common presentations include complete or partial bowel obstruction, heme-positive stools, a palpable mass and incidental finding on imaging [1,2]. The classic triad of abdominal pain, a palpable mass and passage of red currant jelly stools seen in children is rarely seen in adult patients [2].…”

Section: Discussionmentioning

confidence: 99%

“…The less common presentations include complete or partial bowel obstruction, heme-positive stools, a palpable mass and incidental finding on imaging [1,2]. The classic triad of abdominal pain, a palpable mass and passage of red currant jelly stools seen in children is rarely seen in adult patients [2]. Multiple diagnostic studies have been utilized to diagnose intussusception, including computed tomography (CT), ultrasound scan, small bowel contrast study, and magnetic resonance imaging.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Adult idiopathic ileocolic intussusception: A case report

Bannai¹,

Pais²

2016

IJCRI

View full text Add to dashboard Cite

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.com Adult idiopathic ileocolic intussusception: A case reportMasaki Bannai, Antonio Pais ABSTRACT Introduction: Intussusception is a rare cause of acute abdomen in adults. Traditionally, management of adult intussusception has mandated surgical interventions due to a high incidence of malignant lesion resulting in intussusception. However, recent literature challenges the traditional view of mandatory surgical interventions for all adult intussusceptions due to an increasing number of benign and idiopathic cases. These benign and idiopathic cases of adult intussusceptions are more readily identified partly due to recent widespread use of computed tomography imaging technique. With the growing number of idiopathic cases, recent literature recommends against the traditional mandatory operative exploration of all adult intussusceptions, only advocating surgical interventions for selected cases. Case Report: A 38-year-old female presented with an acute onset of severe right-sided abdominal pain with associated nausea, vomiting and rectal bleeding to our emergency department. Her computed tomography scan of abdomen and pelvis showed an ileocolic intussusception which had advanced to the level of the hepatic flexure without any mass lesion. The patient underwent an emergency ileocecal resection with side-to-side anastomosis of terminal ileum to ascending colon. Conclusion: This case report adds to literature with evaluation of the rare form of adult intussusception without a lead point. There may be a role for a conservative management approach of subtypes with high incidence of primary malignant lesions in the absence of a lead point on a CT scan especially among young patients without any concerning features.

show abstract

Management of intussusception in patients with melanoma

Perez

Sun

Farley

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background Increased cross‐sectional imaging for surveillance of metastatic melanoma has led to more diagnoses of asymptomatic intussusception. Methods We performed a multi‐institutional retrospective review of patient records with a history of metastatic melanoma and a diagnosis of intussusception. Patients were divided into three groups: 1) asymptomatic patients without current evidence of melanoma (no evidence of disease [NED]); 2) asymptomatic intussusception and known active metastatic melanoma; 3) symptomatic intussusception and known active metastatic melanoma; the number of patients requiring surgery and intraoperative findings were recorded. Results We reviewed 73 patients diagnosed with intussusception from 2004 to 2017. Among asymptomatic patients with NED (n = 16), 14 spontaneously resolved and 2 underwent pre‐emptive surgery without abnormal intraoperative findings. Of asymptomatic patients with active metastatic disease (n = 32), 25 were initially observed and 7 underwent pre‐emptive surgery and 9 of the 25 initially observed patients required surgery for development of symptoms. In this group, all 16 patients undergoing surgery (50% of the group) had intraoperative findings of intussusception and/or metastatic intestinal melanoma.. All symptomatic patients with metastatic melanoma (n = 25) underwent surgery; all had intraoperative findings of intussusception and/or metastatic melanoma except 1 (Meckel's diverticulum). Conclusion Asymptomatic patients with NED do not require surgery and intussusception will likely resolve spontaneously. Asymptomatic patients with known metastatic melanoma may be initially observed, but a low threshold for surgery should be maintained. Symptomatic patients with known metastases should undergo surgery.

show abstract

Adult Intussusception in the Last 25 Years of Modern Imaging: Is Surgery Still Indicated?

Cited by 72 publications

References 22 publications

Ileo-ileal intussusception due to lipomatous growth

Ileo-ileal intussusception due to lipomatous growth

Adult idiopathic ileocolic intussusception: A case report

Management of intussusception in patients with melanoma

Contact Info

Product

Resources

About