An early diagnostic symptom in chronic intussusception.

THE clinical diagnosis of chronic intussusception in adults is notoriously difficult. Unless a mass is palpable in the abdomen, or the intussusception reveals itself on rectal examination, there may be little more to go on than vague abdominal pain and indefinite signs. Preoperative diagnosis is rarely made; out of 28 cases of spontaneous sloughing and healing collected by Robb and Souter (1962), only three were diagnosed before operation. In more than half of all patients, symptoms go on for over three months before diagnosis is reached (Bond and Roberts, 1964), and should there be an underlying benign tumour, the length of time before detection may average fifteen months (Sanders, Hagan and Kinnaird, 1958). Nevertheless, early diagnosis is important for a number of reasons. A 'third of all cases have an underlying malignancy (Sanders and others, 1958). Furthermore, intussusception in its fully developed form is a strangulation obstruction (Roper, 1956), and its prognosis correspondingly worse. Lastly, if chronic intussusception due to carcinoma is recognised early, the prognosis is better than in uncomplicated carcinoma, as intussusception implies mobility and a long, unfixed mesentery. (Teasdale, 1953). Three cases of adult intussusception have been seen at the General Hospital, Rochford, in the past year. All had one striking symptom in common: that of colicky albdominal pain within