Differentiation Between Surgical and Nonsurgical Intussusception: A Diagnostic Model Using Multi-Detector Computed...

Area of Science:

• Radiology
• Gastroenterology
• Surgical Diagnosis

Background:

• Differentiating surgical from nonsurgical adult intussusception is crucial for appropriate management.
• Multidetector computed tomography (MCDT) is a key imaging modality in evaluating intussusception.

Purpose of the Study:

• To assess the diagnostic capability of MCDT features in distinguishing surgical from nonsurgical adult intussusception.
• To develop a diagnostic model for adult intussusception management.

Main Methods:

• Retrospective analysis of 99 intussusceptions in 96 adult patients (2014-2020).
• Radiological review of MCDT images to document intussusception characteristics.
• Development of a diagnostic tree model based on identified features.

Main Results:

• Lead point presence, length (≥5.0 cm), diameter (≥3.2 cm), interposed fat thickness (≥0.5 cm), and complications predicted surgical cases (p < 0.001).
• The diagnostic tree model achieved 97% accuracy in classifying 99 intussusceptions.
• Colon intussusceptions (98.4%) and enteroenteric intussusceptions with lead points (79.2%) were predominantly surgical.

Conclusions:

• MCDT is vital for diagnosing and guiding the management of adult intussusceptions.
• A systematic approach using MCDT-derived features and a diagnostic tree model can effectively differentiate surgical from nonsurgical cases.