Adult intussusception in Northern India.
BACKGROUND
Adult intussusception is infrequently encountered in Asians. The diagnosis is often late because of the variable presentation. The optimal treatment is not universally agreed upon.


OBJECTIVE
To determine the causes and management of this uncommon entity in India.


METHODS
A retrospective review of patients with postoperative diagnosis of intussusception between March 2003 and March 2008 was conducted in a tertiary care centre in North India. Data relating to diagnosis, treatment and histopathology was analyzed.


RESULTS
Twenty-seven patients, aged 15-72 years with 28 intussusceptions were studied. Four patients (14.29%) had acute presentation, 16 (57.14%) subacute and 7 (25%) had chronic symptoms. The most common type of intussusception was enteroenteric. A diagnosis of intussusception on contrast enhanced computed tomogram was made in 84% and a lead point was identified in 89%. A causative factor could be identified in 89% (25 out of 28 intussusceptions) which was malignant in 37% and benign in 48%. The most common underlying malignant lesions were adenocarcinoma (50%), and lymphoma (25%). Among benign lesions, small bowel polyps were the most common (57%). All cases underwent surgical intervention. Bowel resection was performed in 89%. There was no mortality.


CONCLUSIONS
Our series highlights a high frequency of a demonstrable cause of intussusception in a tropical country. Overall our results are similar to those reported from other countries. Resection of the involved bowel is recommended because of high incidence of underlying pathology.
Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Vikas
V
Gupta
Rudra Prasad
RP
Doley
Kishore Gurumoorthy
KG
Subramanya Bharathy
Thakur Deen
TD
Yadav
Kusum
K
Joshi
Naveen
N
Kalra
Mandeep
M
Kang
Rakesh
R
Kochhar
Jai Dev
JD
Wig
D000293:Adolescent; D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery; D004378:Duodenal Diseases / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D007194:India; D007414:Intestinal Neoplasms / Q000150:complications; D007443:Intussusception / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult