World Journal of Surgery

, Volume 37, Issue 8, pp 1872–1877

Contemporary Management of Adult Intussusception: Who Needs a Resection?

  • Oliver A. Varban
  • Ali Ardestani
  • Dan E. Azagury
  • Bela Kis
  • David C. Brooks
  • Ali Tavakkoli
Article

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.

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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Oliver A. Varban
    • 1
  • Ali Ardestani
    • 2
  • Dan E. Azagury
    • 2
  • Bela Kis
    • 3
  • David C. Brooks
    • 2
  • Ali Tavakkoli
    • 2
  1. 1.Department of General SurgeryUniversity of Michigan Health SystemAnn ArborUSA
  2. 2.Department of Gastrointestinal and General SurgeryBrigham and Women’s HospitalBostonUSA
  3. 3.Department of RadiologyBrigham and Women’s HospitalBostonUSA

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