Intussusception in adults: what radiologists should know

Abstract

Adult intussusception (AI) is a rare entity with an organic lesion within the intussusception in 70-90% of the cases. Intussusception is classified according to location, etiology, and to the presence or not of a lead point. We illustrate several causes of AI with a variety of radiological findings on plain film, ultrasonography, computed tomography, magnetic resonance, and endoscopy seen at our institution. Imaging plays a major role in their diagnosis and in determining the appropriate treatment.

Intermittent adult ileocecal intussusception: a case report and review of literature

“…In case of (suspected) malignancy, it is a useful staging investigation. 2,9 Abdominal ultrasound is, in contrast to the paediatric population, not the first choice imaging technique in adult intussusception with a reported diagnostic accuracy of only 60% (significantly increasing to 92% in the case of a palpable abdominal mass). 10,12 Typical signs are the 'target sign' in the transverse plane and the 'pseudokidney' sign in the sagittal plane.…”

“…10,12 Typical signs are the 'target sign' in the transverse plane and the 'pseudokidney' sign in the sagittal plane. 9,13 Colour Doppler can provide additional information about the blood supply to the affected bowel segment. 12 Magnetic resonance imaging with a reported diagnostic accuracy of 96% is an alternative for computed tomography and can show nearly the same features seen on CT imaging.…”

Adult jejunojejunal intussusception in the face of jejunal adenocarcinoma: two infrequently encountered entities

“…Preoperative diagnosis ranges from 30% to 70% 2 12. Abdominal CT represents the most accurate diagnostic modality with the possibility of demonstrating lead points, vascular compromise and possible associated complications such as intestinal obstruction or local spread 13. Other modalities such as X-ray, ultrasound and barium studies have been less reliable in achieving a diagnosis 13.…”

“…Abdominal CT represents the most accurate diagnostic modality with the possibility of demonstrating lead points, vascular compromise and possible associated complications such as intestinal obstruction or local spread 13. Other modalities such as X-ray, ultrasound and barium studies have been less reliable in achieving a diagnosis 13. In established cases of CI, colonoscopy may play a role either preoperatively or intraoperatively in identifying a causal lesion 5…”

Adult intussusception presenting as rectal prolapse

“…Unlike in children where most cases of intussusception are idiopathic, 70% of cases of intussusception in adults are due to an underlying neoplasm, and usually malignant if located in the large bowel 2. Rectal prolapse as a first presentation of underlying malignancy is by itself uncommon with only a handful of cases being reported 3.…”