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Intussusception in adults: institutional review.
Rakesh Kr Gupta1, Chandra Shekhar Agrawal, Rohit Yadav
1Gastrointestinal (GI) Unit, Department of Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal. rakesh154@yahoo.co.in
International Journal of Surgery (London, England)
|October 19, 2010
Summary
Adult intussusception (AI) is rare and often presents as bowel obstruction. CT scans are highly effective for diagnosis, with colonoscopy being most accurate for ileocolic and colonic AI, guiding surgical treatment.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Diagnostic Imaging
Background:
- Adult intussusception (AI) is distinct from pediatric intussusception.
- AI accounts for 1% of all bowel obstructions and 5% of all intussusceptions.
Purpose of the Study:
- To review the diagnosis and treatment of adult intussusception (AI).
Main Methods:
- Retrospective review of adult patients (≥18 years) with a postoperative diagnosis of AI.
- Data collected from 2003-2009 at B.P.K.I.H.S.
Main Results:
- Thirty-eight cases of surgically proven AI were identified.
- Intestinal obstruction was the most common presentation (71%).
- Diagnostic accuracy: ultrasonography 78.5%, CT scan 90%, colonoscopy 100%.
Conclusions:
- AI necessitates a high index of suspicion; CT scanning is the most useful radiologic diagnostic method.
- Colonoscopy is highly accurate for ileocolic and colonic AI.
- Surgical treatment is standard; reduction is preferred for suspected benign small-bowel AI, while large bowel AI typically requires resection without reduction due to high malignancy rates.
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