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Intussusception in adults: institutional review
L K Eisen1, J D Cunningham, A H Aufses
1Department of Surgery, The Mount Sinai Medical Center, New York, NY, USA.
Journal of the American College of Surgeons
|April 9, 1999
Summary
Adult intussusception is rare and often requires surgery. This study found that colonic intussusceptions should be resected without reduction, while small bowel cases may be reduced selectively.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Imaging
Background:
- Adult intussusception is an uncommon condition with varied causes, distinct from pediatric cases.
- Optimal management strategies for adult intussusception remain debated.
- Understanding the etiology and treatment outcomes is crucial for patient care.
Purpose of the Study:
- To investigate the causes of adult intestinal intussusception.
- To evaluate the role of intestinal reduction in the management of adult intussusception.
- To inform treatment guidelines for this rare condition.
Main Methods:
- Retrospective review of 27 adult patients (≥16 years) diagnosed with intestinal intussusception.
- Analysis of patient data including presentation, diagnosis, treatment, and pathology.
- Categorization of lesions by location (small bowel vs. colon) and malignancy.
Main Results:
- Abdominal pain was the most frequent symptom; preoperative diagnosis was made in 40% of cases.
- 85% of intussusceptions had a pathologic cause, with malignancy rates of 36% in small bowel and 80% in colonic lesions.
- Resection alone was performed in 58% of patients; resection after reduction in 42%.
Conclusions:
- A selective operative approach is recommended for adult intussusception.
- Colonic intussusceptions warrant resection without prior reduction due to high likelihood of adenocarcinoma.
- Small bowel intussusception reduction should be reserved for cases with preoperatively diagnosed benign etiology or to prevent short gut syndrome.