Postoperative intussusception in the adult: a previously unrecognized entity?

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Intussusception in adults is uncommon and often presents differently than in children.
• Postoperative intussusception is a distinct entity that can occur after abdominal surgery.

Purpose of the Study:

• To review the clinical features, etiologic factors, and management of intussusception in adult patients during the postoperative period.
• To differentiate postoperative intussusception from de novo intussusception in adults.

Main Methods:

• Retrospective review of adult patients with intussusception at the Mayo Clinic between 1955 and 1978.
• Analysis of clinical presentation, surgical history, and treatment outcomes for 73 adult patients.

Main Results:

• Twenty-five of 73 adult patients (34%) experienced intussusception in the postoperative period.
• Clinical presentation and likely etiologic factors (adhesions, suture lines, motor abnormalities) resembled those seen in children.
• Surgical management typically involved reduction and lysis of adhesions; resection was infrequent.
• No recurrences were observed in the study cohort.

Conclusions:

• Postoperative intussusception in adults is a recognizable condition with clinical features similar to those in children.
• Intra-abdominal adhesions and surgical factors are likely contributors to postoperative intussusception.
• Surgical intervention, primarily reduction and adhesiolysis, is effective, with a low rate of recurrence.