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Intestinal Intussusception: Etiology, Diagnosis, and Treatment
Priscilla Marsicovetere1, S Joga Ivatury2, Brent White1
1Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Geisel School of Medicine, Hanover, New Hampshire.
Clinics in Colon and Rectal Surgery
|February 2, 2017
Summary
Intussusception, bowel telescoping, is common in children but rare in adults. Adult cases often involve a lead point, necessitating surgical resection due to potential malignancy.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Radiology
Background:
- Intussusception involves one bowel segment telescoping into another.
- Ileocolic intussusception is common in children, treated nonoperatively.
- Adult intussusception is rare, often small bowel, and linked to lead points.
Purpose of the Study:
- To differentiate intussusception characteristics in pediatric versus adult populations.
- To analyze the significance of lead point pathology in adult intussusception.
- To review diagnostic and management strategies for adult intussusception.
Main Methods:
- Review of medical literature on intussusception in children and adults.
- Analysis of intussusception etiology, diagnosis, and treatment outcomes.
- Emphasis on cross-sectional imaging (CT/MRI) findings.
Main Results:
- Adult intussusception frequently presents with bowel obstruction due to a lead point.
- Small bowel intussusception lead points are often benign or metastatic (e.g., melanoma).
- Colonic intussusception lead points are frequently primary adenocarcinoma; observation is possible for asymptomatic cases.
Conclusions:
- Adult intussusception management hinges on lead point identification and malignancy risk.
- Surgical resection is often indicated for symptomatic adult intussusception.
- Increasingly frequent imaging detects incidental intussusceptions, allowing for observation.
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