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Intestinal intussusception

Susan M Cera1

  • 1Physicians Regional Medical Center, Medical Surgical Specialists, Naples, FL 34119, USA. susan.cera@pmc.hma.org

Clinics in Colon and Rectal Surgery
|December 17, 2009
PubMed

Insights

Intussusception, or bowel telescoping, differs in children and adults. Pediatric cases are often idiopathic and treated nonoperatively, while adult intussusception requires surgery due to lead points, posing diagnostic challenges.

Area of Science:

  • Gastroenterology
  • Pediatric Surgery
  • Surgical Oncology

Background:

  • Intussusception involves bowel telescoping, with distinct causes and management in pediatric versus adult patients.
  • Pediatric intussusception is frequently idiopathic, often ileocolic, linked to developmental and infectious factors.
  • Adult intussusception typically arises from a lead point (mucosal, intramural, or extrinsic) causing bowel invagination.

Purpose of the Study:

  • To delineate the differing etiologies, diagnostic approaches, and treatment strategies for intussusception in pediatric and adult populations.
  • To highlight the diagnostic challenges and controversial intraoperative management in adult intussusception.
  • To contrast the standardized nonoperative approach in children with the surgical necessity in adults.

Main Methods:

  • Review of existing literature on pediatric and adult intussusception.
  • Comparative analysis of diagnostic modalities and treatment outcomes.
  • Examination of etiological factors, including lead points in adults and idiopathic causes in children.

Main Results:

  • Pediatric intussusception commonly presents as ileocolic and is managed with nonoperative reduction (air/contrast enemas).
  • Adult intussusception is associated with a lead point, necessitating surgical intervention.
  • Diagnosis in adults is challenging preoperatively, and intraoperative management remains a subject of debate.

Conclusions:

  • Intussusception management requires distinct strategies based on patient age due to differing underlying causes and diagnostic considerations.
  • Early diagnosis and appropriate intervention are crucial for both pediatric and adult intussusception.
  • Further research may clarify optimal intraoperative management for adult intussusception.

Keywords:
Intussusceptionintestinal obstruction

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