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Adult intussusception in a tropical setting: real-world surgical diagnosis in low-resource settings
Mohammed E H Azoz1, Abdelmoniem M M Makkawi1, Ahmed A F Dawood2
1Faculty of Medicine, University of El Imam El Mahdi, Kosti City, Sudan.
Background:
Adult intussusception is a rare clinical condition, accounting for only a small proportion of bowel obstructions in adults. The study aimed to investigate the etiology, presentation, and management of adult cases of intussusception at our center.
Methods:
A retrospective review was conducted of eight adult patients diagnosed with intussusception between 2020 and 2023.
Results:
The study included eight patients, four male and four female. The patients were aged between 22 and 55 years. Seven patients (87.5%) presented with features of intestinal obstruction, with abdominal pain as the primary symptom in all patients. One patient (12.5%) had symptoms mimicking acute appendicitis. All intussusceptions were in the small intestine. Ileocecal intussusception was the most common type (87.5%), followed by one case of jejunojejunal intussusception. Pathological lead points were detected in seven cases; all were benign, including lipoma, hemangioma, leiomyoma, inflammatory polyp, bilharzia, and abdominal tuberculosis. One pregnant patient had no identifiable lesion. All patients underwent bowel resection with primary anastomosis. No mortality occurred, though two patients developed minor postoperative complications (incisional hernias).
Conclusion:
Intussusception in adults is rare and often difficult to diagnose. The small bowel is frequently affected by this condition, which is commonly caused by benign lesions, particularly in regions where tuberculosis and schistosomiasis are endemic. Surgical resection remains the primary treatment, and when appropriately managed, good outcomes are expected.
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