Tumor spectrum of adult intussusception.
BACKGROUND
Adult intussusception is rare. Most general and colorectal surgeons are unfamiliar with its etiology and optimal management.


METHODS
Patients older than 16 years and diagnosed with intestinal intussusception between January 1990 and June 2006 were retrospectively reviewed. Data related to presentation, diagnosis, treatment, and pathology were analyzed.


RESULTS
Seventy-two patients underwent surgery for intestinal intussusception. Neoplasm was identified as the cause of intussusception in 66 (92%) cases, and 6 (8%) were idiopathic. The incidence of malignant colonic intussusception (63%) was significantly higher than that of enteric intussusception (20%), P = 0.001. Primary colon adenocarcinoma (8 of 10 patients, 80%) and malignant lymphoma (2 of 10 patients, 20%) were the two most common underlying malignant lesions in the colon. Lipoma (15 of 40 patients, 38%) and Peutz-Jegher adenoma (10 of 40 patients, 25%) were the two most common lesions of benign small bowel neoplasms while 27% (3 of 11) of malignant enteric intussusception cases were malignant lymphoma and metastatic respectively.


CONCLUSIONS
Lipoma is the most common benign tumor in both small and large bowel intussusception. Whereas 80% of tumors associated with small bowel intussusception were benign, two-thirds of colonic intussusceptions had resulted from primary adenocarcinoma.
Chiang
Jy-Ming
JM
Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing St., Kuei-Shan, Tao-Yuan [corrected] Taiwan. jmjiang@adm.cgmh.org.tw [corrected]
Lin
Yann-Sheng
YS
D015746:Abdominal Pain / Q000209:etiology; D000230:Adenocarcinoma / Q000150:complications; D000236:Adenoma / Q000150:complications; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018282:Cystadenocarcinoma, Mucinous / Q000150:complications; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology* / Q000601:surgery; D007414:Intestinal Neoplasms / Q000150:complications*; D007443:Intussusception / Q000209:etiology* / Q000601:surgery; D008067:Lipoma / Q000150:complications; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications; D008297:Male; D008875:Middle Aged; D010580:Peutz-Jeghers Syndrome / Q000150:complications; D012189:Retrospective Studies