The diagnosis and management of adult intussusception.
BACKGROUND
While intussusception is relatively common in children, it is a rare clinical entity in adults, where the condition is almost always secondary to a definable lesion.


METHODS
Thirteen cases of intussusception occurring in individuals older than 16 were encountered at our institute between 1981 and 1994.


RESULTS
Presenting signs/symptoms included recurrent bowel obstruction, intermittent pain, and red blood per rectum. Correct preoperative diagnosis was made in six patients using colonoscopy, flexible sigmoidoscopy, upper gastrointestinal (GI) series and computed tomography (CT). At surgery the lead point was identified in the small intestine in eight cases, in the colon in four cases, and one small intestinal intussusception was considered idiopathic. Twelve patients underwent laparotomy and one patient was both diagnosed and treated by colonoscopy alone.


CONCLUSIONS
Adult intussusception is an unusual cause of bowel obstruction. The likelihood of neoplasia, particularly in the colon as a cause, is high. Operative management is thus almost always necessary.
Begos
D G
DG
Yale University School of Medicine, Department of Surgery, New Haven, CT 06520-8062, USA.
Sandor
A
A
Modlin
I M
IM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003106:Colon / Q000000981:diagnostic imaging; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications / Q000175:diagnosis; D007414:Intestinal Neoplasms / Q000150:complications / Q000175:diagnosis; D007421:Intestine, Small / Q000000981:diagnostic imaging; D007443:Intussusception / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012812:Sigmoidoscopy; D014057:Tomography, X-Ray Computed