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Murine Ileocolic Bowel Resection with Primary Anastomosis
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Adult intussusception: 5-year experience in Sarawak.

S L Siow1, C H Chea, A R Hashimah

  • 1Department of Surgery, Sarawak General Hospital, Jalan Hospital, 93586 Kuching, Sarawak, Malaysia. szeli18@yahoo.com

The Medical Journal of Malaysia
|November 25, 2011
PubMed
Summary

Adult intussusception is rare but often linked to underlying pathology. Early diagnosis via CT scans and tailored surgical approaches, like resection for colonic cases, are crucial for effective management.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Abdominal Imaging

Background:

  • Adult intussusception is an uncommon condition, accounting for only 5% of all intussusceptions and 1% of bowel obstructions.
  • It frequently presents with variable symptoms and is associated with an underlying pathological process in 90% of cases.

Purpose of the Study:

  • To review the experience of adult intussusception in Sarawak, Malaysia, focusing on clinical features, diagnosis, and treatment.
  • To address the lack of regional data on this rare entity.

Main Methods:

  • Retrospective review of 14 surgically proven adult intussusception cases over 5 years.
  • Analysis of clinical presentation, diagnostic procedures (including CT scan accuracy), and treatment outcomes.
  • Categorization of intussusceptions into enteric and colonic types.

Main Results:

  • The mean age of patients was 45.9 years, with 9 enteric and 5 colonic intussusceptions.
  • Pathological lesions were present in 93% of cases; 33% of enteric lesions were malignant, and 80% of colonic lesions were malignant.
  • Computed tomography (CT) scan demonstrated an 83% diagnostic accuracy for intussusception.

Conclusions:

  • Adult intussusception necessitates a high index of suspicion due to its association with significant pathology, particularly malignancy in colonic cases.
  • CT scans are valuable diagnostic tools for non-specific abdominal symptoms or suspected bowel obstruction.
  • Surgical management should involve en bloc resection for colonic intussusception and a selective approach for enteric intussusception.