Abstract
Unlike pediatric intussusception, intestinal intussusception is infrequent in adults and it is often secondary to a pathological condition. The growing use of Multi-Detector Computed Tomography (MDCT) in abdominal imaging has increased the number of radiological diagnoses of intussusception, even in transient and nonobstructing cases. MDCT is well suited to delineate the presence of the disease and provides valuable information about several features, such as the site of intussusception, the intestinal segments involved, and the extent of the intussuscepted bowel. Moreover, MDCT can demonstrate the complications of intussusceptions, represented by bowel wall ischemia and perforation, which are mandatory to promptly refer for surgery. However, not all intussusceptions need an operative treatment. In this paper, we review the current role of MDCT in the diagnosis and management of intussusception in adults, focusing on features, as the presence of a leading point, that may guide an accurate selection of patients for surgery.
Highlights
Intestinal intussusception in adults is considered uncommon, accounting for an estimated 5% of all intussusceptions and representing only 1% of intestinal obstructions [1, 2]
Intestinal intussusception is infrequent in adults and it is often secondary to a pathological condition
We review the current role of Multi-Detector Computed Tomography (MDCT) in the diagnosis and management of intussusception in adults, focusing on features, as the presence of a leading point, that may guide an accurate selection of patients for surgery
Summary
Intestinal intussusception in adults is considered uncommon, accounting for an estimated 5% of all intussusceptions and representing only 1% of intestinal obstructions [1, 2]. We review the current role of MDCT in the diagnosis and management of intussusception, focusing on features that may guide an accurate selection of adult patients for surgery, both in small bowel and large bowel intussusceptions. The diagnosis of intussusception is often an incidental finding on MDCT performed for other reasons [17] In these cases, most of the time, the small bowel intussusception is selflimited; the length of intussusception is the most reliable predictive indicator of the outcome. Clinical diagnosis can be difficult even in symptomatic patients with a leading point intussusception, because of the variety of clinical findings at presentation (crampy abdominal pain, nausea, vomiting, and bloody mucoid stools), depending on the underlying cause. Complicated intussusceptions, with bowel wall engorgement due to impaired mesenteric circulation and signs of parietal ischaemia, are associated with a higher risk of perforation and peritonitis [3, 5]
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