Adult intussusception:A retrospective review of 41 cases

AIM:To optimize the preoperative diagnosis and surgical management of adult intussusception (AI).METHODS:A retrospective review of the clinical features,diagnosis,management and pathology 41 adult patients with postoperative diagnoses of intussusception was conducted.RESULTS:Forty-one patients with 44 intussusceptions were operated on,24.4% had acute symptoms,24.4% had subacute symptoms,and 51.2% had chronic symptoms.70.7% of the patients presented with intestinal obstruction.There were 20 enteric,15 ileocolic,eight colocolonic and one sigmoidorectal intussusceptions.65.9% of intussusceptions were diagnosed preoperatively using a computed tomography (CT) scan (90.5% accurate) and ultrasonography (60.0% accurate,rising to 91.7% for patients who had a palpable abdominal mass).Coloscopy located the occupying lesions of the lead point of ileocolic,colocolonic and sigmoidorectal intussusceptions.Four intussusceptions in three patients were simply reduced.Twenty-one patients underwent resection after primary reduction.There was no mortality and anastomosis leakage perioperatively.Except for one patient with multiple small bowel adenomas,which recurred 5 mo after surgery,no patients were recurrent within 6 mo.Pathologically,54.5% of the intussusceptions had a tumor,of which 27.3% were malignant.9.1% comprised nontumorous polyps.Four intussusceptions had a gastrojejunostomy with intestinal intubation,and four intussusceptions had no organic lesion.CONCLUSION:CT is the most effective and accurate diagnostic technique.Colonoscopy can detect most lead point lesions of non-enteric intussusceptions.Intestinal intubation should be avoided.