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Intussusception in adult and pediatric patients: two different entities
Arda Demirkan1, Aydin Yağmurlu, Ilknur Kepenekci
1Department of General Surgery, Ankara University, Ankara, Turkey.
Insights
Adult intussusception is rare and differs significantly from pediatric cases in symptoms, diagnosis, and treatment. Understanding these differences is crucial for effective clinical management in both age groups.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Abdominal Imaging
Background:
- Intussusception is a common pediatric abdominal emergency.
- Adult intussusception is rare, presenting unique diagnostic and management challenges.
Purpose of the Study:
- To delineate the distinct clinical presentations, diagnostic strategies, and treatment modalities for intussusception in pediatric versus adult patients.
- To emphasize the need for age-specific clinical perspectives in managing intussusception.
Main Methods:
- Retrospective analysis of 40 intussusception cases over 14 years.
- Evaluation of symptoms, diagnostic methods, intussusception sites, associated pathologies, and treatments.
Main Results:
- Pediatric patients (31) commonly presented with bloody stool and vomiting; adults (9) with abdominal pain.
- Diagnosis in children relied more on physical exam, while adults required imaging.
- Adult intussusception frequently involved underlying pathologies and surgical intervention, unlike pediatric cases managed nonoperatively or surgically.
Conclusions:
- Significant disparities exist in the clinical presentation, diagnostic pathways, and management of intussusception between pediatric and adult populations.
- Age-specific approaches are essential for optimal patient outcomes in intussusception management.
Purpose:
Intussusception is one of the most common abdominal emergencies in pediatrics, but adult intussusception is an uncommon entity and most surgeons have only limited experience in treating this disease. The purpose of this study was to highlight the differences between pediatric and adult intussusception.
Methods:
The records of 40 patients during 14 years were reviewed retrospectively. The symptoms, diagnosis, sites of intussusception, associated pathologies, and treatment methods of each patient were analyzed.
Results:
A total of 31 pediatric and 9 adult patients were included in the study. In the pediatric group, bloody stool and vomiting were the most common symptoms whereas adult patients commonly presented with abdominal pain. The physical examination was diagnostic in a remarkable proportion of the pediatric patients but the diagnosis was suggested based on imaging techniques in the adults, and preoperative diagnosis was more successful in the pediatric group. Intussusception was more often associated with an underlying pathology in adults and no adult patient underwent nonoperative reduction, whereas pediatric patients were managed either with hydrostatic reduction or surgery.
Conclusions:
Although intussusceptions occur at all ages, there are major differences in the clinical presentation, diagnostic approach, and management between pediatric and adult populations. Intussusception is remarkably different in these two age groups and it must be approached from a different clinical perspective.
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