Title: Adult Intussusception: Diagnosis and Management Strategies. 10 Years Experience from North India

Authors: Javid Iqbal* MS FMAS, FIAGES, Yasmeen Kousar MBBS, DGO, Lileswar Kaman, MS, MRCS, Rajinder Singh, MS

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.40

Abstract

Background and aims: Adult intussusception is a rare clinical presentation and often not considered clinically in patients with vague abdominal complaints. Even if the diagnosis is established, the optimal management of this problem remains controversial.

Materials and Methods: The clinical, diagnostic, operative and pathological data of 25 patients of adult intussusception was collected prospectively between June 2007 to June 2017 at two tertiary health centers of North India and was analyzed for varied clinical spectrum, diagnostic techniques and surgical treatment.

Results:  Twenty five patients of adult intussusception aged between 18-82 years were included in this study. Most common presenting complaint was pain abdomen in 21/25 patients (84%) followed by nausea and vomiting. CT scan established preoperative diagnosis in 87.5% cases. All patients underwent surgical treatment and there was no mortality in our series. Pathological lead point was detected in 21/25 patients, in one patient it was due to feeding tube and etiology was not detected in three patients. No case with malignant lead point was detected in enteric intussusception group as compared to four cases in colonic intussusception group.

Conclusion: CT scan the most sensitive investigation for preoperative diagnosis. Enteric intussusception should be reduced when the underlying etiology is suspected to be benign or the resection is massive without reduction. But not the colonic intussusception as etiology is malignant in most cases.

Keywords: Adult intussusception, intussusceptum, computed tomography, reduction, surgery.

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