Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 28, 2009; 15(16): 1985-1989
Published online Apr 28, 2009. doi: 10.3748/wjg.15.1985
Intussusception in adults: Clinical characteristics, diagnosis and operative strategies
Savas Yakan, Cemil Calıskan, Ozer Makay, Ali Galip Deneclı, Mustafa Ali Korkut
Savas Yakan, Ali Galip Deneclı, Department of Surgery, Izmir Education and Research Hospital, Izmir 35270, Turkey
Cemil Calıskan, Ozer Makay, Mustafa Ali Korkut, Department of Surgery, Ege University Faculty of Medicine, Izmir 35100, Turkey
Author contributions: Yakan S, Calıskan C and Makay O designed the research; Yakan S and Calıskan C performed the research; Korkut MA, Deneclı AG analyzed the data; Yakan S wrote the paper; all of the authors read and approved final version.
Correspondence to: Savas Yakan, Department of Surgery, Izmir Education and Research Hospital, Izmir 35270, Turkey. savasyakan@gmail.com
Telephone: +90-533-4717940
Fax: +90-232-2614444
Received: February 6, 2009
Revised: March 23, 2009
Accepted: March 30, 2009
Published online: April 28, 2009
Abstract

AIM: To evaluate 20 adults with intussusception and to clarify the cause, clinical features, diagnosis, and management of this uncommon entity.

METHODS: A retrospective review of patients aged > 18 years with a diagnosis of intestinal intussusception between 2000 and 2008. Patients with rectal prolapse, prolapse of or around an ostomy and gastroenterostomy intussusception were excluded.

RESULTS: There were 20 cases of adult intussusception. Mean age was 47.7 years. Abdominal pain, nausea, and vomiting were the most common symptoms. The majority of intussusceptions were in the small intestine (85%). There were three (15%) cases of colonic intussusception. Enteric intussusception consisted of five jejunojejunal cases, nine ileoileal, and four cases of ileocecal invagination. Among enteric intussusceptions, 14 were secondary to a benign process, and in one of these, the malignant cause was secondary to metastatic lung adenocarcinoma. All colonic lesions were malignant. All cases were treated surgically.

CONCLUSION: Adult intussusception is an unusual and challenging condition and is a preoperative diagnostic problem. Treatment usually requires resection of the involved bowel segment. Reduction can be attempted in small-bowel intussusception if the segment involved is viable or malignancy is not suspected; however, a more careful approach is recommended in colonic intussusception because of a significantly higher coexistence of malignancy.

Keywords: Adult; Intussusception; Diagnosis; Therapy; Surgery