Intussusception in adults: a 21-year experience in the university-affiliated emergency center and indication for nonoperative reduction
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Hiroaki Omori1, Hiroshi Asahi, Yoshihiro Inoue
1Department of Surgery I, Iwate Medical University, Morioka, Japan. homori@mte.biglobe.ne.jp
Background:
While intussusception is relatively common in children, it is rare in adults.
Methods:
We retrospectively reviewed the records of all patients older than 18 years with the diagnosis of intussusception between 1981 and 2001.
Results:
Eleven patients with surgically or endoscopically proven intussusception were encountered at the University-affiliated emergency center. The patients ranged in age from 19 to 88 years with a mean age of 45 years. Males predominated by a ratio of 7:4. Most patients (82%) presented with symptoms of bowel obstruction. The mean duration of symptoms was 4.5 days with a range of 4 h to 25 days. Correct pre-treatment diagnosis was made in 82% of the patients using abdominal ultrasonography and computed tomography (CT). The causes of intussusception were organic lesions in 64% of the patients, postoperative in 18% and idiopathic in 18%, respectively. 73% of patients had emergency operations, and an attempt at nonoperative reduction was performed and completed successfully in 3 patients with ileo-colic or colonic type of intussusception. There have been no cases of morbidity or mortality in our series and no recurrence has occurred up to the present time.
Conclusions:
Abdominal ultrasonography and CT were effective tools for the diagnosis of intussusception. Patients with ileo-colic and colonic intussusception without malignant lesions could be good candidates for nonoperative reduction prior to definitive surgery.
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