Abstract
Introduction: Intussusception is rate in adults and is usually secondary to a definable pathology. This study was designed to review adult intussusception, including presentation, diagnosis, and pathology.
 Methods: A retrospective study of 18 cases of intussusception in individuals older than 18 years of age visiting the department of surgery of Civil Service Hospital from 2010 to 2018 was done.
 Results: There were 18 cases of adult intussusception. The mean age was 49.2 years (range 19-84 years). Abdominal pain and vomiting were the commonest symptoms. The median duration of presentation was 5 days (range 20 hours to 10 months). Three patients (16.6%) presented with generalized peritonitis. There were eight ileocolic, seven ileoileal, and three colocolic intussusceptions. Two patients (11.1%) settled spontaneously. Twelve out of the 18 patients (66.6%) had leading lesions. Benign pathologies were seen in seven cases (38.8%) and malignant in five patients (27.7%). All malignancies were in the large bowl
 Conclusions: Adult intussusception is a rare entity, nearly one-third of their causes are malignant. Surgery is the best recommended treatment, with or without a primary reduction of the intussusception; the latter can result in more limited bowel resection.
Highlights
Adult intussusception is a rare entity, nearly one-third of their causes are malignant
Intussusception was preoperatively diagnosed with ultrasonography with the target and doughnut signs on transverse view and the pseudo-kidney sign in the longitudinal view, and/or contrast-enhanced computed tomography of the abdomen with the characteristic sausage or target sign, bowel-within-bowel appearance in more than one image with or without a lead point and bowel obstruction, inclusion of mesenteric fat or vessels, bowel wall edema, and fat stranding, and mesentery in the lumen.4,5 7KH LQWXVVXVFHSWLRQV ZHUH FODVVL¿HG DFFRUGLQJ to the location and pathological lead-points into three FDWHJRULHV LOHRLOHDO FRQ¿QHG WR WKH VPDOO ERZHO (2) ileocolic and (3) colo-colic; and according to the etiology into benign, malignant or idiopathic.[7]
There were three patients with intussusception who presented with peritonitis, the reason being delay in presentation to our hospital
Summary
There were 18 patients in our study. There was a slight female predominance: 11 females (62 %) and seven males (38 %). One with ileocolic and another with ileoileal intussusception were planned for surgical intervention but they improved over a few hours, with the disappearance of the symptoms and lump. They underwent a colonoscopy and a barium meal follow-through later to identify the lesion, but they revealed a normal study, and on follow-up, they did not have any symptoms. Two patients (11.1%) improved without surgical intervention They were normal on later examinations, so the exact cause the intussusception was not known. They were grouped under the ileocolic intussusception the aetiology were in the caecum
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