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Adult intussusception: a single-center 10-year experience

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Summary

Background

Adult intussusception (AI) is a rare condition, usually with a lead point, and for which surgery is the treatment of choice. Given the risks and possible complications of untreated AI, an accurate preoperative diagnosis is of the utmost importance. Although AI remains difficult to diagnose, computerized tomography (CT) is presently considered the best diagnostic tool.

Methods

Sixteen patients of 20 years and older with intraoperative diagnosis of intussusception, who underwent surgery between January 2000 and December 2009, were reviewed retrospectively. Patients were assessed concerning clinical presentation, imagiological findings, surgical treatment, and postoperative histological evaluation.

Results

Most patients (93.8 %) were admitted via emergency room (ER) due to abdominal pain. Fourteen (87.5 %) AI cases showed an underlying organic cause, e.g., masses or tumors. The most frequent comorbidities were Peutz–Jeghers syndrome (PJS; 18.8 %) and HIV (12.5 %). Eight (50.0 %) intussusceptions were ileocolic and six (37.5 %) were in the small bowel. Total 43.8 % of lesions were malignant. Preoperative diagnosis of intussusception was possible in 50.0 % of cases by ultrasonography (US) and in 81.8 % by CT. US showed no predictive value concerning intussusception location. Total 27.3 % of CTs correctly identified the location, but only 9 % accurately identified the lead point.

Conclusions

We propose that all AI cases should be treated with surgical resection without attempting reduction, even when no lead point is detected by imaging studies, and this approach should be based on the oncological criteria. CT can be regarded as the most accurate diagnostic tool for intussusception, although its predictive value concerning location and lead point is still far from ideal.

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Conflict of interest

With regards to the original paper entitled “10 years of adult intussusception cases”, submitted to European Surgery, the authors declare that there is no conflict of interest. No funding was received to support this work.

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Authors and Affiliations

  1. B Surgery Department, Hospital Prof. Doutor Fernando Fonseca, Estrada IC-19, 2720-276, Amadora, Portugal

    A. Gomes MD, M. Sousa MD, N. Pignatelli MD & V. Nunes MD

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  2. M. Sousa MD
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Correspondence to A. Gomes MD.

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Gomes, A., Sousa, M., Pignatelli, N. et al. Adult intussusception: a single-center 10-year experience. Eur Surg 45, 239–244 (2013). https://doi.org/10.1007/s10353-012-0188-2

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