title: Contemporary management of adult intussusception: who needs a resection?
abstract: BACKGROUND
  Surgical resection is often recommended in adults with intestinal intussusception (AI) because of its potential association with malignancy. We provide a contemporary algorithm for managing AI by focusing on the probability of discovering a lead point.
  
  
  METHODS
  This is a retrospective study of adult patients with computed tomography (CT)-confirmed intussusception who underwent operative management of AI between 1996 and 2011 at a single academic institution.
  
  
  RESULTS
  Sixty-four patients were diagnosed with AI by CT scan and then managed operatively. The incidence of colonic (CI), small bowel (SBI), and retrograde intussusception (RI) was 14, 55, and 31 %, respectively. All patients with CI had a lead point, whereas none were found among patients with RI. Some 46 % of patients with SBI had a lead point. The probability of discovering a lead point in SBI was increased by past history of malignancy (RR, 3.7, p < 0.001), a mass seen on preoperative CT scan (RR, 2.9, p = 0.005), and age over 60 years (RR, 2.2, p = 0.07).
  
  
  CONCLUSIONS
  A pathologic lead point is likely with CI but not with RI. Patients with SBI who are over the age of 60 years and have a history of malignancy or a mass noted on CT scan have a higher likelihood of harboring a pathologic lead point.
authors.affiliation: Department of General Surgery, University of Michigan Health System, 2210 Taubman Center, 1500 E Medical Center Drive, Ann Arbor, MI 48109-5343, USA. ovarban@med.umich.edu
authors.forename: Oliver A
authors.initials: OA
authors.lastname: Varban
authors.forename: Ali
authors.initials: A
authors.lastname: Ardestani
authors.forename: Dan E
authors.initials: DE
authors.lastname: Azagury
authors.forename: Bela
authors.initials: B
authors.lastname: Kis
authors.forename: David C
authors.initials: DC
authors.lastname: Brooks
authors.forename: Ali
authors.initials: A
authors.lastname: Tavakkoli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007443:Intussusception / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult