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Intestinal invagination in adults: preoperative diagnosis and management

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aims

Intestinal invagination in adults is an uncommon but potentially serious condition that is usually diagnosed during surgery by the presence of a mechanical obstructive syndrome. We report a series of adults with intestinal invagination and discuss preoperative diagnosis and surgical procedures.

Patients and methods

We analyzed the files of all the seven patients aged over 18 years with a postoperative diagnosis of intestinal invagination and treated at our center between 1996 and 2000.

Results

Preoperative causal diagnosis was established in six cases by ultrasonography and computed tomography. All the patients received surgery, three as emergency and four programmed. The lesions causing the invagination were: three benign (Meckel's diverticulum, inflammatory pseudotumor, fibroid polyp) and one malignant (degenerative villous adenoma polyp) located in the terminal ileum, two malignant lesions in the cecum (both adenocarcinomas over a polyp), and in the remaining case a double lymphoma of the jejunum and ileum. The intussusceptions were ileoileal in three cases and ileocolic in four. We performed intestinal resection in six cases and one excision of Meckel's diverticulum.

Conclusion

Preoperative diagnosis of intussusception was possible in most cases. Sonography and computed tomography proved the most effective and useful preoperative diagnostic methods. In adults colonic invagination is almost always malignant while small bowel is almost always benign. Invagination in adults must be clarified by surgery, and intestinal resection is the procedure of choice.

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References

  1. Azar T, Berger DL (1997) Adult intussusception. Ann Surg 226:134–138

    Article  CAS  PubMed  Google Scholar 

  2. Piñero A, Rios A, Castellanos G, Carrasco M, Parrilla P (1998) lntestinal invagination in the adult. Gastroenterol Hepatol 21:398–400

    PubMed  Google Scholar 

  3. Matter I, Assaff Y, Nash E, Kunin J, Cohen O, Eldar S (1997) Intussusception in adults. S Afr J Surg 34:194–197

    Google Scholar 

  4. Gordon RS, O'dell KB, Namon AJ, Becker LB (1991) Intussusception in the adult. A rare disease. J Emerg Med 9:337–342

    CAS  PubMed  Google Scholar 

  5. AIvarez A, Ciriza C, Garcia J, Sanchez A, Diaz-Rubio M (1995) Invaginación ileal dependiente de leiomioma como causa de obstrucción intestinal intermitente. An Med lntern 12:505–507

    Google Scholar 

  6. Akcay MN, Polat M, Cadirci M, Gencer B (1994) Tumor induced ileoileal invagination in adults. Am Surg 60:980–981

    CAS  PubMed  Google Scholar 

  7. Eirbil Y, Eminoglu L, Calis A, Berber E (1997) Ileocolic invagination in adult due to caecal carcinoma. Acta Chir Belg 97:190–191

    PubMed  Google Scholar 

  8. Carels RA, lbelings MG, Jongsma CK, Wismans PJ (1997) lnvagination in adults. Ned Tijdschr Geneeskd 141:2122–2126

    CAS  PubMed  Google Scholar 

  9. Alkim C, Sasmaz N, Alkim H, Caglikulekci M, Turhan N (2001) Sonographic findings in intussusception caused by a lipoma in the muscular layer of the colon. J Clin Ultrasound 29:298–301

    Article  CAS  PubMed  Google Scholar 

  10. Naganuma H, Ishida H, Konno K, Komatsuda T, Sato M, Funaoka M, Fujimori S (1999) Intussusception in Peutz-Jeghers syndrome: sonographic findings. Abdom Imaging 24:333–335

    Article  CAS  PubMed  Google Scholar 

  11. Sato M, Ishida H, Konno K, Komatsuda T, Naganuma H, Watanabe S, Kotanagi H, Ishida J (2000) Long-standing painless intussusception in adults. Eur Radiol 10:811–813

    Article  CAS  PubMed  Google Scholar 

  12. Daneman A, Myers M, Shuckett B, Alton DJ (1997) Sonographic appearances of inverted Meckel diverticulum with intussusception. Pediatr Radiol 27:295–298

    Article  CAS  PubMed  Google Scholar 

  13. Visvanathan R, Nichols TT, Reznek RH (1997) Acquired inmune deficiency syndrome related intussusception in adults. Br J Surg 84:1539–1540

    CAS  PubMed  Google Scholar 

  14. Cerro P, Magrini L, Porcari P, De Angelis O (2000) Sonographic diagnosis of intussusceptions in adults. Abdom Imaging 25:45–47

    Article  CAS  PubMed  Google Scholar 

  15. Gritzmann N, Hollerweger A, Macheiner P, Rettenbacher T (2002) Transabdominal sonography of the gastrointestinal tract. Eur Radiol 12:1748–1761

    Article  PubMed  Google Scholar 

  16. Fujii Y, Taniguchi N, Itoh K (2002) Intussusception induced by villous tumor of the colon: sonographic findings. J Clin Ultrasound 30:48–51

    Article  PubMed  Google Scholar 

  17. Farrokh D, Saadaoui H, Hainaux B (1996) Contribution of imaging in intestinal intussusception in the adult. A propos of a case of ileocolic intussusception secondary to cecal lipoma. Ann Radiol (Paris) 39:213–216

    Google Scholar 

  18. Gayer G, Apter S, Hofmann C, Nass C, Amitai M, Zissin R, Hertz M (1998) Intussusception in adults: CT diagnosis. Clin Radiol 53:53–57

    CAS  PubMed  Google Scholar 

  19. Berkelhammer C, Caed D, Mesleh G, Bolanos J, McGinnis P, Zeiger H (1997) lleocecal intussusception of small bowel lymphoma: diagnosis by colonoscopy. J Clin Gastroenterol 25:358–361

    Article  CAS  PubMed  Google Scholar 

  20. Chekan EG, Westcott C, Low VH, Ludwig KA (1998) Small bowel intussusception and laparoscopy. Surg Laparosc Endosc 8:324–326

    Article  CAS  PubMed  Google Scholar 

  21. Begos DG, Sandor A, Modlin IM (1997) The diagnosis and management of adult intussusception. Am J Surg 173:88–94

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of General Surgery, Hospital General Universitario J.M. Morales Meseguer, C/Marqués de los Vélez s/n, 30008, Murcia, Spain

    J. G. Martín-Lorenzo, A. Torralba-Martinez, R. Lirón-Ruiz, B. Flores-Pastor, J. Miguel-Perelló, J. Aguilar-Jimenez & J. L. Aguayo-Albasini

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  1. J. G. Martín-Lorenzo
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  2. A. Torralba-Martinez
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  3. R. Lirón-Ruiz
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  4. B. Flores-Pastor
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  5. J. Miguel-Perelló
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  6. J. Aguilar-Jimenez
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  7. J. L. Aguayo-Albasini
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Correspondence to J. G. Martín-Lorenzo.

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Martín-Lorenzo, J.G., Torralba-Martinez, A., Lirón-Ruiz, R. et al. Intestinal invagination in adults: preoperative diagnosis and management. Int J Colorectal Dis 19, 68–72 (2004). https://doi.org/10.1007/s00384-003-0514-z

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  • DOI: https://doi.org/10.1007/s00384-003-0514-z

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