Adult intussusception: a retrospective review of 41 cases.
OBJECTIVE
To optimize the preoperative diagnosis and surgical management of adult intussusception (AI).


METHODS
A retrospective review of the clinical features, diagnosis, management and pathology 41 adult patients with postoperative diagnoses of intussusception was conducted.


RESULTS
Forty-one patients with 44 intussusceptions were operated on, 24.4% had acute symptoms, 24.4% had subacute symptoms, and 51.2% had chronic symptoms. 70.7% of the patients presented with intestinal obstruction. There were 20 enteric, 15 ileocolic, eight colocolonic and one sigmoidorectal intussusceptions. 65.9% of intussusceptions were diagnosed preoperatively using a computed tomography (CT) scan (90.5% accurate) and ultrasonography (60.0% accurate, rising to 91.7% for patients who had a palpable abdominal mass). Coloscopy located the occupying lesions of the lead point of ileocolic, colocolonic and sigmoidorectal intussusceptions. Four intussusceptions in three patients were simply reduced. Twenty-one patients underwent resection after primary reduction. There was no mortality and anastomosis leakage perioperatively. Except for one patient with multiple small bowel adenomas, which recurred 5 mo after surgery, no patients were recurrent within 6 mo. Pathologically, 54.5% of the intussusceptions had a tumor, of which 27.3% were malignant. 9.1% comprised nontumorous polyps. Four intussusceptions had a gastrojejunostomy with intestinal intubation, and four intussusceptions had no organic lesion.


CONCLUSIONS
CT is the most effective and accurate diagnostic technique. Colonoscopy can detect most lead point lesions of non-enteric intussusceptions. Intestinal intubation should be avoided.
Wang
Ning
N
General Surgery Department, the First Affiliated Hospital, China Medical University. Shenyang 110001, Liaoning Province, China. wn232@hotmail.com
Cui
Xing-Yu
XY
Liu
Yu
Y
Long
Jin
J
Xu
Yuan-Hong
YH
Guo
Ren-Xuan
RX
Guo
Ke-Jian
KJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007443:Intussusception / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult