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Tropical intussusception in adults.

R Rasaretnam, C B Kumarakulasinghe, H L Eaton

    The Australian and New Zealand Journal of Surgery
    |February 1, 1976
    PubMed
    Summary
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    In Sri Lanka, adult intussusception, particularly caecocolic type, is common, often caused by amoebic granulomas. Surgical intervention yields excellent outcomes for this condition.

    Area of Science:

    • Gastroenterology
    • Surgical Pathology
    • Tropical Medicine

    Background:

    • Intussusception incidence differs significantly between Western countries and Sri Lanka.
    • Adult intussusception constitutes approximately 50% of cases in Sri Lanka, peaking in the fourth decade.
    • Caecocolic intussusception, rare in the West, is frequently reported in tropical regions.

    Purpose of the Study:

    • To analyze adult intussusception cases in Sri Lanka.
    • To investigate the etiology and clinical presentation of caecocolic intussusception.
    • To evaluate the efficacy of surgical management for adult intussusception.

    Main Methods:

    • Retrospective analysis of 76 adult intussusception cases.
    • Clinical data review, including physical examination findings.

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  • Histological examination of resected specimens to determine underlying causes.

    • Main Results:

    • 62 out of 76 cases were caecocolic intussusception.
    • A palpable abdominal mass was present in 90% of patients, aiding diagnosis.
    • Amoebic granulomatous formation in the cecal diverticulum was identified as the predisposing cause for caecocolic intussusception.
    • Gangrene was absent in caecocolic cases, even with prolonged illness.
    • Surgical manipulation was required for irreducibility in some cases.

    Conclusions:

    • Amoebic granulomas in the cecum predispose to chronic caecocolic intussusception in adults in Sri Lanka.
    • Surgical exploration and manipulation are effective for complete reduction of intussusceptions.
    • Excellent surgical outcomes are achievable for adult intussusception, particularly the caecocolic type.