The role of laparoscopy in adult bowel obstruction caused by intussusception.
OBJECTIVE
The intestinal intussusception in the adult represent 1% of all occlusions. Organic causes are detectable in 90% of cases. Aim of this study is to discuss the diagnostic and therapeutic iter of adult intestinal intussusception with particular emphasis on role of laparoscopy.


METHODS
We retrospectively considered 10 cases of intussusception between January 2000 and January 2013, demographic and clinical issue, location of invagination, the type of surgical treatment, the post-operative morbidity and mortality and histological nature of occlusion cause.


RESULTS
Ten (F: M 1.5:1) patients were admitted in emergency with bowel obstruction, the median age was 50 years (r.18-91). All required surgical treatment. Three patients (30%) underwent a totally laparoscopic procedure, four patients (40%) laparoscopic exploration followed by laparotomy, three patients (30%) open surgery directly. The invagination was ileo-ileal (50%), ileo-colonic (40%) and colo-colonic (10%). Nine out of ten underwent to surgical resection. The malignancy was the most frequent cause.


CONCLUSIONS
In case of colonic intussusception should not be performed any reduction because the frequent association with neoplastic disease. The laparoscopy can be safe and effective to allow, in entero-enteric and entero-colic intussusception, the definitive treatment of the occlusion. In the case of colo-colonic intussusception laparoscopy is a valuable diagnostic aid and can facilitate the later processing.


CONCLUSIONS
The intestinal invaginations diagnosis can often be difficult. Laparoscopy is safe and effective in the diagnosis and treatment of adult intussusception.
Dario
D
Tartaglia
Andrea
A
Bertolucci
Matteo
M
Palmeri
Emanuele Federico
EF
Kauffmann
Niccolò
N
Napoli
Christian
C
Galatioto
Piero Vincenzo
PV
Lippolis
Giuseppe
G
Zocco
Massimo
M
Seccia
D000293:Adolescent; D000328:Adult; D003106:Colon; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D007443:Intussusception / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult