ADULT INTUSSUSCEPTION – A SURGICAL DILEMMA

Authors

  • M A Rathore
  • S I H Andrabi
  • M Mansha

Abstract

Background: Adult intussusception is rare. It is expected to be found in 1/30,000 of all hospitaladmissions, 1/1300 of all abdominal operations, 1/30–1/100 of all cases operated for intestinalobstruction and one case of adult intussusception for every 20 childhood ones. Methods: Theauthors encountered 4 cases of adult intussusception. M:F ratio was 1:1. Mean age was 47years.Small bowel obstruction was documented in all. They were investigated by radiographs,ultrasound exam, barium studies, endoscopy and CT scan. Results: All however were diagnosedat operation although some pre-operative suspicion was raised in one case. All had a laparotomy.Two were ileo-ileal and two ileo-caecal intussusceptions. One was chronic intussusceptions andthree sub-acute. One intussusception had a malignancy (lymphoma) as a lead point. Two had asubmucous lipoma at the apex. In an interesting case the suture knot from a recent small bowelanastomosis (2-3 weeks prior) was forming the lead point of the intussusception! The 2 ileo-ilealintussusceptions had segmental resection. Right hemicolectomy was done for the 2 ileo-caecalcases. “Target lesion” and leumen-within-leumen were the CT hallmarks on review. Retrospectivebarium enema review failed to show the intussusception. This may suggest the intussusceptionmay have been recurrent or chronic. All 4 recovered uneventfully and remained well. One patientwas referred for chemotherapy for intestinal lymphoma. Conclusion: Adult intussusceptionremains a rare cause of abdominal pain. The treatment almost always is surgical.Key words: Adult Intussusception

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Issue

Vol. 18 No. 3 (2006): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

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ORIGINAL ARTICLE

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