Les invaginations intestinales de l’adulte. À propos de 21 cas au centre hospitalier universitaire Yalgado Ouédraogo de Ouagadougou

Abstract

IntroductionThe intussusception is a common abdominal emergency in children but rare in adults. The aim of our study was our experience in the management of this disease.Patients and methodsA retrospective study of 21 cases of intussusception in adults undergoing surgery in emergency visceral Centre Hospitalier Universitaire Yalgado Ouedraogo (CHUYO) from 1 January 2004 to September 30, 2009.ResultsWe observed 21 cases of intussusception. They accounted for 5.4% of occlusions. There were 9 men and 12 women with a mean age of 42 years. The average period of consultation was 9.42 days. The clinical picture was that of acute generalized peritonitis in 5 cases of acute intestinal obstruction in 7 cases and in 9 patients, it was a painful abdominal mass. Radiograph of the abdomen without preparation had objectified air fluid levels in 13 cases. Abdominal ultrasound was performed in 12 patients allowed the diagnosis in 9 cases. Surgical exploration found 11 had ileo-ileal intussusception, ileocaecal 1, 4-caeco ileo-colic, a colo-colic and colic-caeco 4. These invaginations were tumor-induced inflammation in 5 cases and in 4 cases. They were primitive in 12 cases. The invaginated bowel was viable in 13 cases, necrosis in 8 cases including one case of perforation. Bowel resection was done in 19 cases. The postoperative course was uneventful in 20 cases. The death occurred in one patient.ConclusionThe intussusceptions in adults are rare. History of abdominal pain and / or sub-recurring occlusions must be sought to make an early diagnosis aided by imaging. The frequency of organic causes in adults requires a surgical treatment in all cases.