ROLE OF MDCT IN THE PREOPERATIVE EVALUATION OF ADULT INTUSSUSCEPTION

Abstract

Introduction: Intussusception is a condition which occurs when one segment of the intestine "telescopes" inside of another segment . It may or may not be associated with features of intestinal obstruction .The telescoping proximal segment is called intussusceptum and the distal receiving bowel segment is called intussuscipien.Intussusception can occur due to congenital cause like Meckel diverticulum, benign cause like intestinal polyps, intestinal lipomas, hypertrophied lymphnodes, malignant conditions like colorectal carcinoma , lymphomas , metastatic depostis. Depending on the presence or absence of lead point on MDCT,further treatment planning can be done like surgical or non surgical options like water soluble contrast enema/ air enema can be administered . The prese Material and Methods: nt study was conducted in the department of radiodiagnosis, NRI general hospital,chinakakani, Guntur district from 2020 to 2022. A total of 40 patients attending the general surgery department in the age group between 20 to 70 years abdominal symptoms like pain,vomittings,bleeding per rectum, intestinal obstruction were studied. All patients underwent MDCT and the ndings of CT scan are noted. Out Results: of the total 40 patients the most common age group of presentation was 41-50 years(30%). 72% were males and 28% were females.out of 40 patients location of intussusception is ileocaecal in 50%,enteric in 35% ( ileoileal in 20%,jejunojejunal in 13% duodenoduodenal in 2%),colocolic in 15%. Intusussception can be detected by USG in 72% ,not detected by USG in 28% of individuals. Out of 40 patients no evidence of lead point on MDCT detected in 20%,In rest 80% lead point is neoplastic etiology out of which 55% are benign( Lipomas being most common 22%, polyps 20%,carcinoids 8%,GIST 5% ), Malignant being 25% (carcinoma 15%, lymphoma 10 %). In case of adults neoplastic being most common cause sugery is the denitive management in 90% patients , reduction is done in rest 10% patients. Preoperative evaluation of i Conclusion: ntussusception patients with MDCT is very essential to diagnose the presence or absence of lead point and determine appropriate treatment and reduce the rate of unnecessary surgical intervention.