Diagnosis and treatment of adult intussusception

Twenty adults were treated for intussusception in two large hospitals from 1969 to 1988. Fourteen intussusceptions originated in the small intestine and 6 in the large intestine. Diagnosis was reached preoperatively in only 10 patients, probably due to the atypical clinical picture. In addition to a high degree of suspicion, careful examination of plain abdominal radiograph and ultrasonography are helpful in diagnosing adult intussusception. In 18 of 20 patients, an organic lesion causing intussusception was found. In six patients the cause was a malignancy. In such cases surgical treatment is necessary. In jejunojejunal and ileoileal intussusceptions, an attempt at primary reduction followed by resection or enterotomy is justified. In most cases of ileocolic, ileocecocolic, and colocolic intussusception, primary resection is the treatment of choice, especially in patients over 60 years old because of the high incidence of malignancy.