title: Liver transplantation: A new risk factor for intestinal intussusceptions.
abstract: BACKGROUND
  Intestinal intussusception in adults is associated with chronic inflammatory bowel disease, celiac disease, abdominal tumors or previous abdominal surgery but most often of unknown origin.
  
  
  OBJECTIVE
  The aim of our study was to evaluate circumstances and identify risk factors for intussusceptions.
  
  
  METHODS
  All 65,928 abdominal ultrasound examinations performed at our tertiary medical center between January 2001 and June 2008 were analyzed retrospectively for the diagnosis "intussusception". After identifying individuals with sonographically proven intussusception we analyzed various patients' characteristics including age, gender and underlying disease as well as sonographic findings such as localization of the intussusception, absence or presence of ascites and lymph nodes.
  
  
  RESULTS
  We identified 32 cases of intussusceptions [mean age 45 years (range 18 to 88); 18 patients were male]. Twelve patients (38%) had a history of abdominal surgery including 8 patients who had undergone liver transplantation (2 patients with primary sclerosing cholangitis, 1 patient with cystic fibrosis, 1 patient with sarcoidosis, 1 patient with hepatocellular carcinoma and HCV infection, 1 patient with autoimmune hepatitis, 1 patient with Crigler-Najar-syndrome and one patient with echinococcus). A hepaticojejunostomy had been performed in 4 of the patients after liver transplantation. Liver transplanted patients were significantly overrepresented in the intussusceptions group compared with the overall cohort of patients undergoing abdominal ultrasound examination (25% vs. 8%, Chi-Square-test, p = 0.0023).
  
  
  CONCLUSIONS
  In our retrospective study liver transplantation, in particular with hepaticojejunostomy, was identified as a new major risk factor for intestinal intussusceptions
authors.affiliation: Hannover Medical School, Gastroenterology, Hepatology and Endocrinology, Germany. pischke.sven@mh-hannover.de
authors.forename: Sven
authors.initials: S
authors.lastname: Pischke
authors.forename: Wursthorn
authors.initials: W
authors.lastname: Karsten
authors.forename: Johannes
authors.initials: J
authors.lastname: Hadem
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schmidt
authors.forename: Karl
authors.initials: K
authors.lastname: Heiringhoff Heinz
authors.forename: Fabian
authors.initials: F
authors.lastname: Helfritz
authors.forename: Christian P
authors.initials: CP
authors.lastname: Strassburg
authors.forename: Joachim
authors.initials: J
authors.lastname: Lobers
authors.forename: Lars
authors.initials: L
authors.lastname: Zender
authors.forename: Oktay
authors.initials: O
authors.lastname: Tutarel
authors.forename: Jochen
authors.initials: J
authors.lastname: Wedemeyer
authors.forename: Michael P
authors.initials: MP
authors.lastname: Manns
authors.forename: Heiner
authors.initials: H
authors.lastname: Wedemeyer
authors.forename: Kinan
authors.initials: K
authors.lastname: Rifai
authors.forename: Michael
authors.initials: M
authors.lastname: Gebel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005858:Germany; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007410:Intestinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D007443:Intussusception / Q000000981:diagnostic imaging / Q000209:etiology*; D007582:Jejunostomy / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects*; D008206:Lymphatic Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents