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Intussusception in adults: what radiologists should know

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Abstract

Adult intussusception (AI) is a rare entity with an organic lesion within the intussusception in 70–90% of the cases. Intussusception is classified according to location, etiology, and to the presence or not of a lead point. We illustrate several causes of AI with a variety of radiological findings on plain film, ultrasonography, computed tomography, magnetic resonance, and endoscopy seen at our institution. Imaging plays a major role in their diagnosis and in determining the appropriate treatment.

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Author information

Correspondence to Sandra Baleato-González.

Electronic supplementary material

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A 33-year-old woman with history of bariatric surgery Roux en Y gastric by-pass. CT scans show the classic target sign involving distal Roux limb and resultant mild dilatation of proximal portion of the roux limb. Coronal CT (video 4) and surgical procedure (video 5) demonstrate jejuno-jejunal intussusception (MOV 9,822 kb)

Video 1

Ultrasound demonstrating the typical “target sign” appearance of intussusceptions (AVI 5,573 kb)

Video 2

Meckel’s diverticulum in a 26-year-old woman with abdominal pain. CT shows the classic target sign in the right iliac fossa, which is pathognomonic for ileoileal intussusception. Note the central area of fat attenuation surrounded by soft tissue, which is characteristic of an invaginated Meckel’s diverticulum. Intraoperative photograph shows an invaginated Meckel’s diverticulum causing an ileoileal intussusception located 35 cm from the ileocecal valve (Fig. 2; AVI 521 kb)

Video 3

Ileocolocolic intussusception in a 22-year-old man with cystic fibrosis and a 1-week history of abdominal pain. CT scans reveal a sausage-shaped mass with a well-enhanced portion, representing the bowel wall of the intussuscipiens within the intussusceptum at its periphery, and a central fatty density, representing mesenteric fat. Coronal and axial scans show mesenteric fat, vessels, and intussusceptum (ileum and ascending colon) entering the intussuscipiens of the transverse colon (AVI 626 kb)

Video 4

A 33-year-old woman with history of bariatric surgery Roux en Y gastric by-pass. CT scans show the classic target sign involving distal Roux limb and resultant mild dilatation of proximal portion of the roux limb. Coronal CT (video 4) and surgical procedure (video 5) demonstrate jejuno-jejunal intussusception (AVI 2,507 kb)

Video 5

A 33-year-old woman with history of bariatric surgery Roux en Y gastric by-pass. CT scans show the classic target sign involving distal Roux limb and resultant mild dilatation of proximal portion of the roux limb. Coronal CT (video 4) and surgical procedure (video 5) demonstrate jejuno-jejunal intussusception (MOV 9,822 kb)

Video 6

A 72-year-old man with rectosigmoid intussusception secondary to a sigmoid neoplasm. CT demonstrates a central lead point representing an adenocarcinoma (AVI 842 kb)

Video 7

A 53-year-old woman receiving palliative treatment for malignant melanoma with lung and liver metastases presented with 3 days of midabdominal pain and abdominal distension. CT shows small bowel dilatation and multiple ileoileal intussusceptions. Several small bowel metastases can be identified. Intraoperative photographs show the intussusception and smaller implants in the abdominal cavity (Fig. 10; AVI 1,073 kb)

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Baleato-González, S., Vilanova, J.C., García-Figueiras, R. et al. Intussusception in adults: what radiologists should know. Emerg Radiol 19, 89–101 (2012). https://doi.org/10.1007/s10140-011-1006-z

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Keywords

  • Acute abdomen
  • Intussusception
  • Intestinal obstruction
  • Gastrointestinal disease