Adult Intussusception: A Retrospective Review |
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Authors: | Ahmad Zubaidi MD FRCSC Faisal Al-Saif MD FRCSC Richard Silverman MD FRCSC |
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Institution: | (1) Department of Surgery, Saint Boniface Hospital, Winnipeg, Manitoba, Canada;(2) Foot Hills Medical Center, Department of Surgery, 1403-28 St. N.W., Calgary, Alberta, T2N 2T9, Canada |
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Abstract: | Purpose Whereas intussusception is relatively common in children, it is clinically rare in adults. The condition is usually secondary
to a definable lesion. This study was designed to review adult intussusception, including presentation, diagnosis, and optimal
treatment.
Methods A retrospective review of 22 cases of intussusception occurring in individuals older than aged 18 years encountered at two
university-affiliated hospitals in Winnipeg between 1989 and 2000. The 22 cases were divided to benign and malignant enteric,
ileocolic, colonic lesions respectively. The diagnosis and treatment of each case were reviewed.
Results There were 22 cases of adult intussusception. Mean age was 57.1 years. Abdominal pain, nausea, and vomiting were the commonest
symptoms. There were 14 enteric, 2 ileocolic, and 6 colonic intussusceptions. Eighty-six percent of adult intussusception
was associated with a definable lesion. Twenty-nine percent of enteric lesions were malignant. All ileocolic lesions were
malignant. Of colonic lesions, 33 percent were malignant and 67 percent were benign. All cases required surgical interventions
except one.
Conclusions Adult intussusception is a rare entity and requires a high index of suspicion. Our review supports that small-bowel intussusception
should be reduced before resection if the underlying etiology is suspected to be benign or if the resection required without
reduction is deemed to be massive. Large bowel should generally be resected without reduction because pathology is mostly
malignant. |
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Keywords: | Adult intussusception Ileocolic Colocolic Rectocolic Rectorectal Meckel’ s diverticulum Bowel obstruction Barium enema CT scan Colonoscopy Flexible sigmoidoscopy |
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