Adult intussusception: a six-year experience at a single center

OBJECTIVE Adult intussusception (AI) is a rare entity and differs from childhood intussusception in its presentation, etiology, and treatment. It accounts for 1/30,000 of all hospital admissions, 1/1300 of all abdominal operations, 1/30-1/100 of all cases operated for intestinal obstruction and one case of AI for every 20 childhood ones. This study was designed to review the mode of presentation, diagnosis and appropriate treatment and finally the etiology of cases presenting in our hospital over a period of 6 years. METHODS A retrospective review of 15 cases of intussusceptions in individuals older than 18 years presenting to a tertiary referral center of South India during a period of 6 years (2004-2010) was done in respect to mode of presentation, diagnosis, etiology and treatment. RESULTS There were 15 cases of AI. Mean age was 45.5 years. Abdominal pain, nausea and vomiting were the commonest symptoms. There were 8 enteric, 6 ileocolic, and 1 colonic intussusceptions. 73% of AIs were associated with a definable lesion. Only 1 case of enteric lesions had malignancy. All ileocolic lesions were malignant. Twelve of 15 patients underwent surgical intervention. CONCLUSION AI is a rare entity and requires a high index of suspicion. Small-bowel intussusception should be reduced before resection whenever possible if the underlying etiology is suspected to be benign or if the resection required without reduction is deemed to be massive. Large bowel should generally be resected without reduction because pathology is mostly malignant.