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Intestinal Intussusception in Adults: A Systematic Review
Sidney Heersche1,2, Jeanne Hirt1,2, Fabio Butti1,2
1Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne, Switzerland.
World Journal of Surgery
|August 20, 2025
Summary
Adult intestinal intussusception management is debated. This review highlights malignancy risks in colic intussusception, recommending oncological resection, and guides enteric intussusception treatment based on lead points.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Intestinal intussusception management lacks consensus on conservative vs. operative approaches.
- Surgical procedure choice for intussusception is also debated.
Purpose of the Study:
- To systematically review adult intestinal intussusception management.
- To develop a treatment decision algorithm for adult intussusception.
Main Methods:
- Systematic review of PubMed/MEDLINE, Web of Science, Google Scholar, SCOPUS/EMBASE, and Cochrane Library (2004-2024).
- Included studies with >= 20 patients; excluded case reports and small case series.
- Analyzed 37 studies totaling 2330 adult patients.
Main Results:
- Enteric intussusceptions comprised 65%, ileocolic 21%, and colocolic 20%.
- Pathological lead points were found in 58% of cases, with malignancy in 25% (higher in colocolic).
- Operative management occurred in 49%, primarily open surgery (72%).
Conclusions:
- Colic intussusception warrants high suspicion for malignancy, recommending oncological resection without reduction.
- Enteric intussusception management should consider length, presentation, and lead point findings.
- Surgical data were heterogeneous, emphasizing the need for standardized reporting.
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