Adult Intususception: 10-Year Experience in a Medical Center

Abstract

Objective: Adult intussusception is a rare clinical entity. The purpose of this study was to review adult intussusception treated at our hospital and to assess the etiology and management of this uncommon disorder. Methods: A retrospective review of patients older than aged 18 years with a diagnosis of intestinal intussusception between 1997 and 2008 at Tri-Service General Hospital was conducted. Data related to presentation, diagnosis, treatment, and pathology were analyzed. Results: There were 19 cases of surgically proven adult intussusception. There were 12 men and 7 women with a mean age of 54.9 years (range, 19-91 years). There were 11 enteric and 8 colonic intussusceptions, and 79% of patients presented with abdominal pain and 79% of intussusceptions had lead points. The diagnostic accuracy of abdominal computed tomography (CT) was 82%. In enteric intussusceptions, 3 lesions were benign, 2 lesions were idiopathic, and 6 lesions were malignant. In colonic intussusceptions, 4 lesions were benign, 2 lesions were idiopathic, and 2 lesions were malignant. Two patients died of postoperative complications. Conclusions: Adult intussusception is a rare condition and abdominal pain is the most common symptom. Abdominal CT is the most sensitive diagnostic modality. Most adult intussusceptions have lead points and almost half of those are associated with malignancy. Surgical treatment is recommended in adult intussusception and the prognosis after surgery is good, except those with malignant lesions.