Acute Intussusception Research Articles

Acute Intussusception on a Lipoma of the Left Colon in an Adult

Acute Intussusception on a Lipoma of the Left Colon in an Adult

Developing a nomogram to predict recurrent intussusception after pneumatic reduction of primary intussusception in children

BackgroudIntussusception is a common acute abdominal disease in children, often leading to acute ileus in infants and young children.ObjectiveThis study aimed to develop and validate a nomogram for predicting recurrent intussusception in children within 48 h after pneumatic reduction of primary intussusception.MethodsClinical data of children with acute intussusception admitted to multiple hospitals from March 2019 to March 2021 were retrospectively analyzed. The children were divided into a successful reductioncontrol group (control group) and a recurrent intussusception group (RI group) according to the results of pneumatic reduction.ResultsA total of 2406 cases were included in this study, including 2198 control group and 208 RI group. In the total sample, 1684 cases were trained and 722 cases were verified. A logistic regression analysis was conducted to establish a predictive model based on age, abdominal pain time, white blood cells count, and hypersensitive C-reactive protein levels as independent predictors of intussusception recurrence. The nomogram successfully predicted recurrent intussusception after pneumatic reduction.ConclusionIn this study, a nomogram was developed based on clinical risk factors to predict recurrent intussusception following pneumatic reduction in children. Age, abdominal pain time, white blood cell counts, and hypersensitive C-reactive protein levels were identified as predictors and incorporated into the nomogram. Internal validation demonstrated that this nomogram can offer a clear and convenient tool for identifying risk factors for recurrence of intussusception in children undergoing pneumatic reduction.

Epidemiological characteristics, treatment, and outcomes of 586 cases of intussusception: a 4-year retrospective study in China.

This study aims to retrospectively analyze the epidemiological and clinical characteristics of acute intussusception in a tertiary-care pediatric hospital in China over 4 years and evaluate the effectiveness and recurrence of fluoroscopy-guided pneumatic reduction (FGPR) and ultrasound-guided hydrostatic reduction (UGHR). This retrospective study was conducted from January 2019 to December 2022 involving children admitted and managed for acute intussusception in a tertiary-care pediatric hospital in China. The epidemiology, clinical features, and therapeutic effects were analyzed using IBM SPSS Statistics 20.0. The study included 401 boys (68.43%) and 185 girls (31.57%) aged from 2 months to 12 years. The most common symptoms reported were abdominal pain or paroxysmal crying (95.73%), vomiting (45.39%), and bloody stool (7.34%). Vomiting and bloody stool became atypical with increasing age (P < 0.001). The total success cases of reduction accounted for 563 cases (96.08%), and the recurrent cases accounted for 71 cases (12.12%). No significant difference was observed in the success or recurrence rates between FGPR and UGHR (P > 0.05). Abdominal pain was an independent protective factor for successful enema (P < 0.01, OR = 72.46), while bloody stool (P < 0.01, OR = 0.06) and older age were independent risk factors (P < 0.001, OR = 0.51). Of the 71 patients with recurrent intussusception, 29 were successfully reduced by enema, and the other 23 required surgical reduction. Twelve of the surgical cases were secondary intussusception, including three cases of Meckel's diverticulum, five cases of polyps, and four cases of non-Hodgkin lymphoma. The epidemiological characteristics of children with intussusception in Xiamen showed peculiarity with a higher male-to-female ratio, older age at diagnosis, and no significant seasonality. Both FGPR and UGHR were effective and safe for intussusception, and surgical reduction was essential for patients with failed enema reduction.

Developing a Nomogram for Predicting Surgical Intervention in Pediatric Intussusception After Pneumatic Reduction: A Multicenter Study from China.

The objective of this study was to develop and validate a nomogram for predicting the need for surgical intervention in pediatric intussusception after pneumatic reduction. This retrospective study analyzed the clinical data of children with acute intussusception admitted to four hospitals in China from January 2019 to January 2022. Based on the results of pneumatic reduction, the patients were divided into two groups: the successful reduction group (control group) and the failed reduction group (operation group). The total sample was randomly divided into a training set and a validation set in a 7:3 ratio. Logistic regression analysis was performed to establish a predictive model for surgical risk. A total of 1041 samples were included in this study, with 852 in the control group and 189 in the operation group. Among the total sample, 728 cases were used for training and 313 cases were used for validation. Logistic regression analysis of the training set identified age, time of abdominal pain, presence or absence of hematostoecia, C-reactive protein value from blood test on admission, and nested position indicated by B-ultrasound as independent predictors of intussusception intervention. Based on the five independent risk factors identified through multivariate logistic regression, a nomogram was successfully constructed to predict the failure of resetting by air enema under X-ray. A nomogram was developed to predict the need for surgical intervention after intussusception pneumatic reduction in children. The nomogram was based on clinical risk factors including age, time of abdominal pain, presence or absence of blood in stool, value of C-reactive protein in blood test on admission, and nested position indicated by B-ultrasound. Our internal validation demonstrated that this nomogram can serve as a useful tool for identifying risk factors associated with failure of air enema in children with intussusception.

Liberal surgical laparoscopy reduction for acute intussusception: experience from a tertiary pediatric institute

The optimal treatment for acute intussusception has not yet been defined. In this study, we explored whether employing a liberal laparoscopic intervention for intussusception could lead to favorable outcomes. We performed a historical control analysis to evaluate the outcomes associated with this liberal surgical management protocol. This liberal surgical management protocol were revised to incorporate a new protocol centered around the laparoscopic approach. In some cases of acute intussusception, liberal laparoscopic exploration and intervention were undertaken without initial hydrostatic or pneumatic reduction. During the study interval, a retrospective review was conducted on a total of 3086 patients. These were categorized into two groups: 1338 cases before May 2019 (pre-protocol group) and 1748 cases after May 2019 (post-protocol group). Surgical intervention rates in the pre-protoco and post-protocol period were 10.2% and 27.4% respectively (odds ratio [OR] = 0.30 [95% CI 0.25–0.37]; p < 0.001). No significant differences were observed in baseline clinical characteristics or demographic features between the two groups. The duration from admission to operation was longer for the pre-protocol group (p = 0.008) than for the post-protocol group. The post-protocol group demonstrated decreases in both intestinal resection (OR = 1.50 [95% CI 0.96–2.35]; p = 0.048) and total recurrent events (OR = 1.27 [95% CI 1.04–1.55]; p = 0.012) compared to the pre-protocol group. Liberal laparoscopic intervention for intussusception may effectively reduce the risk of intestinal resection and total recurrent events, thereby exhibiting promising outcomes for patients with intussusception.

Primary Trichobezoar in Small Intestine: A Case Report

Trichobezoar is a rare surgical condition that mostly occurs in the stomach and often causes a surgical emergency when left untreated. It is often predisposed by psychiatric conditions, mental retardation, previous gastric surgery, or abnormal anatomy. Trichobezoar progresses extremely slowly and is diagnosed through imaging such as a barium series, endoscopy, or computed tomography. Surgical removal is typically required. The patient in this case was a 12-year-old girl who presented with symptoms of abdominal pain, vomiting, nausea and constipation. She was found to be anaemic and underweight. Contrast-enhanced Computed Tomography (CECT) diagnosed acute intussusception and small bowel obstruction, which were treated by emergency laparotomy. During the operation, a large primary ileal trichobezoar was found in the distal part of the ileum with hair strands extending up to the transverse colon. The absence of masses elsewhere made the diagnosis even more peculiar, as primary intestinal trichobezoar is highly uncommon. Primary closure of the enterotomy was performed as it was viable, and the postoperative period was uneventful. A history of trichophagia was elicited, and a psychiatric assessment of the patient was conducted. Behavioural therapy was initiated for the trichophagia. In conclusion, trichobezoar is a rare surgical entity with modifiable predisposing factors that require a multidisciplinary management approach.

INVAGINATION INTESTINALE AIGUË DE L’ADULTE : ASPECTS DIAGNOSTIQUES, THERAPEUTIQUES A PROPOS DE SEPT CAS DIAGNOSTIQUES AU CHU DE L’AMITIE SINO-CENTRAFRICAINE DE BANGUI, RCA

Objective: To report the diagnostic and therapeutic difficulties of acute intussusception in adults in Bangui, Central African Republic. Patients and method: It was a retrospective descriptive study carried out in the general surgery department of Friendship Sino Centrafricaine University Hospital in Bangui. The reported data run from January 2019 to June 2023. It focuses on the records of adult patients of both sexes who underwent exploratory laparotomy for a bowel obstruction in which intussusception was diagnosed. Results: Intussusception accounted for 1.03% (N:7) of the 674 cases of acute bowel obstruction operated during the period. The mean age of patients was 32.8 years ± 9.7. Male subjects accounted for 57.14% (sex ratio = 1.33). At admission, five patients had occlusive syndrome and the other two had prolapse of a mass through the anus. Laparotomy was used to diagnose intussusception in all cases. These were ileo ileal intussusception (57.1%), ileocecal (14.3%), colo-colic profunated by the anus (14.3%) and ileo-caeco-colic profunted by the anus (14.3%). Surgical procedures consisted of hail resection followed by termino-terminal anastomosis (42.8%), hail resection followed by ileocolic anastomosis (28.6%) and colonic resection, colostomy and restoration of delayed digestive continuity (28.6%).The histopathological study of the operating rooms had found chronic inflammation of the colonic mucosa (28.6%), colonic adenocarcinoma (14.3%), and adenomatous polyp (14.3%). In 3 patients aged 18, 22, and 29 years respectively no cause was found (42.8%). The postoperative follow-up was simple in all operated patients. Conclusion: Intussusception is a rare condition in adults. The diagnosis is often difficult and made on laparotomy. Practitioners' attention should be drawn to prolapsed masses in the anus in adults.

Claudius Amyand’s Hernia in Children: About Two Cases in the Pediatric Surgery Unit in the General Surgery Department at Ignace Deen Chu

Acute intussusception is a rare manifestation in adults, most often of malignant tumoral origin occurring on a small intestine loop. Its presence in a pregnant woman with a complication such as peritonitis by ileal perforation is an extremely rare case. We report a clinical case concerning a 32-year-old woman, amenorrhoeic for 24 weeks, referred to the general and visceral surgery department of the Ignace Deen National Hospital for acute intestinal obstruction in pregnancy in whom, after performing an X-ray of the abdomen without preparation which revealed mixed hydro-aeric levels and a biological assessment, she was taken to the block, at the celiotomy purulent liquid flowed out and the exploration revealed a pudding of ileo-coeco-colic intussusception whose disinvagination revealed three ileal perforations with respective diameters of 1.5cm, 2cm and 3cm located respectively 10cm, 30cm and 50cm from the ileocecal junction with pre-perforation zones. We performed a resection removing the perforations followed by an end-to-side ascending ileocecal anastomosis. The post-operative course was marred by complications such as evisceration, disembowelment and the birth of a full-term stillborn.

Acute Intestinal Intussusception Complicated By Peritonitis by Ileal Perforation in Pregnancy Apropos of a Case in the General and Visceral Surgery Department of the Ignace Deen National Hospital

Acute intussusception is a rare manifestation in adults, most often of malignant tumoral origin occurring on a small intestine loop. Its presence in a pregnant woman with a complication such as peritonitis by ileal perforation is an extremely rare case. We report a clinical case concerning a 32-year-old woman, amenorrhoeic for 24 weeks, referred to the general and visceral surgery department of the Ignace Deen National Hospital for acute intestinal obstruction in pregnancy in whom, after performing an X-ray of the abdomen without preparation which revealed mixed hydro-aeric levels and a biological assessment, she was taken to the block, at the celiotomy purulent liquid flowed out and the exploration revealed a pudding of ileo-coeco-colic intussusception whose disinvagination revealed three ileal perforations with respective diameters of 1.5cm, 2cm and 3cm located respectively 10cm, 30cm and 50cm from the ileocecal junction with pre-perforation zones. We performed a resection removing the perforations followed by an end-to-side ascending ileocecal anastomosis. The post-operative course was marred by complications such as evisceration, disembowelment and the birth of a full-term stillborn.

A CLINICAL STUDY OF INTUSSUSCEPTION IN CHILDREN

A CLINICAL STUDY OF INTUSSUSCEPTION IN CHILDREN

Serum total bile acid levels assist in the prediction of acute intussusception with abdominal type Henoch-Schonlein purpura in children.

The severe acute abdomen associated with Henoch-Schonlein purpura (HSP) is an acute intussusception (AI). There is no reliable specific marker for AI with abdominal-type HSP. The serum total bile acid (TBA) level is a new prognostic marker associated with the severity of intestinal inflammation. The purpose of this study was to identify the prognostic value of serum TBA levels for the diagnosis of AI in children with abdominal-type HSP. A retrospective study of 708 patients with abdominal-type HSP was conducted, with demographic data, clinical symptoms, hepatic function index, immune function markers, and clinical outcomes assessed. Patients were divided into two groups: HSP (613 patients) and HSP with AI (95 patients). The data were analysed using SPSS 22.0. Of the 708 patients, the serum TBA levels were higher in the HSP with AI group than in the HSP group (P < 0.05). Logistic regression analysis showed that vomiting (OR = 396.492, 95% CI = 14.93-10,529.67, P < 0.001), haematochezia (OR = 87.436, 95% CI = 5.944-1,286.214, P = 0.001), TBA (OR = 16.287, 95% CI = 4.83-54.922, P < 0.001), and D-dimer (OR = 5.987, 95% CI = 1.892-15.834, P = 0.003) were independent risk factors for abdominal-type HSP with AI. Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off serum TBA value (sensitivity = 91.58%, specificity = 84.67%, AUC = 93.6524%) was >3 μmol/L for predicting AI in children with abdominal-type HSP. In this group of HSP patients with AI, a serum TBA level ≥6.98 μmol/L was significantly associated with an increased incidence of operative treatment (51.85% vs. 75.61%, P = 0.0181), intestinal necrosis (9.26% vs. 29.27%, P = 0.0117), and length of hospital stay [15.76 ± 5.31 vs. 10.98 ± 2.83 (days), P < 0.0001]. In children with HSP and AI, the serum TBA level was significantly higher. A novel but promising haematological indicator, the serum TBA level, helps identify HSP with and without AI and predicts intestinal necrosis in HSP with AI.

Intestinal intussusception in a child with Peutz-Jeghers syndrome: case report.

A clinical observation of a 5-year-old patient with a complicated course of PJS is presented. Emphasis on recurring episodes of acute abdomen, clinical diagnosis including polyp histopathology, and surgical management is emphasised. While an inpatient, bloodwork demonstrated severe iron deficiency anaemia (haemoglobin 72g/l, red blood cell 3.1×1012/l) and multiple melanin pigmentations measuring 2-4mm in size on the lip mucosa during a physical examination. Erosive duodenopathy and polyposis of the stomach were discovered via fibroesophagogastroduodenoscopy (multiple gastric polyps 5-10mm in size). Acute intussusception of the intestine was discovered by ultrasonography. A mid-median laparotomy was performed alongside manual disinvagination with gut viability intact. Histopathology of excised polyps revealed smooth muscle hyperplasia and Ki67 protein (MIB-1) positivity with small intestinal hamartomatous polyps seen macroscopically. Conservative management was initiated for standard postoperative care and intestinal motility. Patient was discharged 9 days postoperatively. Based on literature data, modern ideas concerning aetiology, diagnosis, and management of patients with PJS are considered. Attention is focused on the high risk of developing cancer of various localisation in PJS, recommendations are given for cancer screening and clinical observation of patients with hereditary gastrointestinal syndromes in childhood.

Epidemiology, clinical characteristics, and treatment of children with acute intussusception: a case series

BackgroundTo summarize the clinical and epidemiological characteristics of acute intussusception.MethodsThis retrospective study included pediatric patients with acute intussusception admitted to the Department of Pediatric Surgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, from January 2014 to December 2019.ResultsA total of 402 infants/children were included (301 males and 101 females) with a mean age of 2.4 ± 1.5 years (2 months to 9 years). Thirty patients (7.5%) had a history of cold food intake, diarrhea, and upper respiratory infection before disease onset. Paroxysmal abdominal pain and crying occurred in 338 patients (84.1%). Eight patients (2.0%) had the typical triad, 167 (41.5%) had vomiting, 24 (6.0%) had bloody stools, and 273 (67.9%) had palpable abdominal mass. The average intussusception depth was 4.0 ± 1.4 cm. Air enema reduction was performed in 344 cases: 335 (97.3%) were successful. Fifty-eight patients were treated with intravenous phloroglucinol (2 mg/kg), and 53 (91.4%) were successful. Sixty-five patients suffered relapses, with a relapse rate of 16.8%.ConclusionsPediatric acute intussusception is common. There was no obvious etiology. The clinical manifestations are mostly atypical. Abdominal pain is the most common complaint. Air enema reduction is an effective treatment. The recurrence rate is high.

Is enema reduction in pediatric intussusception with a history of over 48 h safe: A retrospective cohort study

BackgroundIntussusception is one of the most common acute abdominal diseases in children. Enema reduction is the first-line treatment for intussusception in good condition. Clinically, a history of disease over 48 h is usually listed as a contraindication for enema reduction. However, with the development of clinical experience and therapy, an increasing number of cases have shown that the prolongation of the clinical course of intussusception in children is not an absolute contraindication for enema treatment. This study aimed to analyze the safety and efficacy of enema reduction in children with a history of disease longer than 48 h. MethodsWe conducted a retrospective matched-pair cohort study of pediatric patients with acute intussusception between 2017 and 2021. All patients were treated with ultrasound-guided hydrostatic enema reduction. According to the length of history, the cases were classified into two groups: history <48 h (<48 h group) and history greater than or equal to 48 h (≧48 h group). We generated a 1:1 matched-pair cohort matched for sex, age, admission time, main symptoms, and concentric circle size on ultrasound. Clinical outcomes were compared between the two groups, including success, recurrence, and perforation rates. ResultsFrom January 2016 to November 2021, 2701 patients with intussusception were admitted to the Shengjing Hospital of China Medical University. A total of 494 cases were included in the ≧48 h group, and 494 cases with a history of <48 h were selected for matched comparison in the <48 h group. The success rates of the ≧48 h and <48 h groups were 98.18% vs. 97.37% (p = 0.388), and the recurrence rates were 13.36% vs. 11.94% (p = 0.635), showing no difference according to the length of history. The perforation rate was 0.61% vs. 0%, respectively, with no significant difference (p = 0.247).The comparison of the different history groups showed that in patients with bloody stools, the length of history had no significant effect on the enema reduction outcome(94.90% vs. 86.76%, p = 0.064). ConclusionsUltrasound-guided hydrostatic enema reduction is safe and effective for pediatric idiopathic intussusception with a history of ≧48 h.

Acute Intestinal Invagination in Adults Revealing GIST: Case Report

Acute intussusception is a pathology of infants and young children. Its occurrence in adults is rare. It is of various etiology. In the vast majority of cases, it is secondary to a tumor which can be benign or malignant. We report the case of a 77-year-old patient, admitted to the emergency department of our structure for an acute intestinal obstruction, an abdominal CT scan showed acute small intestine intussusception on a small intestine tumor complicated by perforation. Treatment was open surgical resection. The anatomopathological and immunohistochemical study of the surgical specimen concluded to a small intestine GIST. From this new case and after analysis of the literature, we discuss the clinical and diagnostic characteristics and the therapeutic possibilities of this rare pathology.

Інвагінація кишечника в дітей: навчання та практика

Intestinal invagination is a mixed form of intestinal obstruction that occurs when one section of the intestine is telescopically immersed in the lumen of another and occurs mainly at the age of 3 months to 1 year, which is 90%, and mortality, according to the literature, ranges from 6 to 14.5%. Despite a sufficient number of scientific and clinical publications on the pages of medical journals regarding the diagnosis and treatment of intestinal intussusception, there are no fake simulators in the training of students and interns, which determines the relevance of this publication. Purpose - to improve the results of diagnosis and treatment of children with intestinal intussusception by analyzing domestic developments and visually studying the mechanism of its development with the help of a simulator both for the purpose of diagnosis and treatment - conservative disinvagination. Results. In today’s conditions, general practitioners and pediatricians are not trained to diagnose intussusception in children, that is, they do not have simple methods of examination. Hospitals usually do not have the equipment to examine and diagnose acute intussusception. In order to eliminate the gaps at the Department of Pediatric Surgery of the Bukovinian State Medical University, a dummy-simulator of intestinal intussusception «Garant» was developed and introduced into the educational process. Training on a simulator allows you to master the practical skills of diagnostics in the conditions of an X-ray room and conservative disinvagination followed by X-ray control. In turn, the development of skills by primary care physicians and pediatric surgeons in diagnosis and treatment will primarily improve the understanding of the onset of the disease and treatment methods. Conclusions. With certain and significant developments regarding the diagnosis and treatment of intestinal intussusception in children, the problem has not been solved, since some children seek help at the wrong time, and as a result of complications - necrosis, peritonitis with organ and multiple organ failure. The use of a scoring system for assessing the stage of invagination makes it possible to systematize the main prognostic indicators of sonographic and dopplerographic studies in order to determine an adequate method of treatment. Practicing the skills of diagnosis and treatment on the self-developed dummy «Garant» allows you to clearly understand the essence and purpose of the measures taken to establish and confirm the diagnosis of intestinal intussusception, evaluate the possibilities of various methods of conservative and surgical treatment and indications for them. No conflict of interests was declared by the authors.

Clinical profile and treatment outcome of acute intussusception among children in eastern Ethiopia: A seven years retrospective study.

Acute intussusception is the main cause of abdominal surgical emergencies worldwide in young children, with an incidence of approximately 1 to 4 per 2,000 children. An accurate estimate of the treatment outcomes of acute intussusception in children is unknown in low-and middle-income countries like Ethiopia. Hence, this study aimed to determine the clinical profile, treatment outcomes of acute intussusception and its associated factors among children admitted to Hiwot Fana Specialized University Hospital in eastern Ethiopia. An institutional-based retrospective cross-sectional study was conducted from November 01 to 30, 2021, among children admitted and managed for acute intussusception. All medical records of children admitted and managed for acute intussusception at Hiwot Fana Specialized University hospital between January 2014 and December 2020 were included. Data were collected using pretested structured checklists through a review of medical records, entered and analyzed using Statistical Package for Social Sciences version 25.0. Chi-square (χ 2) tests were applied to determine the associated factors with treatment outcome. The statistical significance was considered at a p-value < 0.05. In this chart review of children, 13.3% (95% CL: 11.8-14.8) died. The median age of the study participant was 13 months. The majority, 72% were male and 76% were less than 24 months old. Regarding the clinical profile; abdominal pain (94.7%), vomiting (93.3%), bloody diarrhea (70.7%), and abdominal distention (76.0%) were the most common clinical presentations. Age less than 24 months [X 2 = 8.13 (df = 1); p = 0.004], preoperative vital signs [X 2 = 19.21 (df = 2); p = 0.000], intraoperative findings [X 2 = 18.89 (df = 1); p = 0.000], and postoperative complications [X 2 = 14.60 (df = 1); p = 0.000] were significantly associated with treatment outcome of acute intussusception. In this chart review, the overall mortality rate in children was relatively high. One in seven children died from acute intussusception. Age less than 24 months, preoperative vital signs, intraoperative findings, and postoperative complications were significantly associated with acute intussusception treatment outcomes. Surgical management was the only treatment performed in all cases. Delayed presentation of patients and lack of other treatment modalities such as non-surgical interventions are serious concerns in this facility. The initiation of non-surgical reduction may reduce the need for surgical intervention-related complications, and child mortality.

Acute intussusception of Meckel’s Diverticulum in a 15-year-old boy: Clinical, imaging and laparoscopy aspects

Acute intussusception on Meckels diverticulum (MD) is a rare cause of abdominal pain requiring emergency surgery. The aim of this study, is to provide an adequate level of clinical knowledge

INTUSSUSCEPTIONS IN ADULTS (ABOUT 06 CASES)

Background : Intussusception in adults is a rare condition that is difcult to diagnose due to its clinical polymorphism. Its diagnosis has become easier thanks to advances in medical imaging. The treatment of intussusceptions in adults is surgical because of the high incidence of causative organic lesions. Our work is a prospective study which aims to determine theObjective : clinical and etiological peculiarities of acute intussusceptions in adults, to specify the diagnostic and therapeutic difculties and to draw practical conclusions regarding the optimal therapeutic management of this rare condition. Our work is a retrospective study,Materials and methods: covering a series of 06 cases of acute intussusception operated on in the visceral surgery department of the Avicenne Military Hospital in Marrakech, over a period of 6 years, from January 2014 to May 2020. Data relating to clinical features, diagnosis, treatment and histological reports were collected and analyzed. Six cases of acute intussusceptions in adults were collected over a period of six years, amountingResults: one case per year. The average age was 52 with a female predominance of 66%. Four out of 6 patients had been seen urgently. The diagnosis was made preoperatively in all cases, ie 100% by using ultrasonography and CT. The ultrasound showed a "target" image in one case and a "pseudo- kidney" image in another. CT made it possible to make the diagnosis in all cases, and objectied an etiological diagnosis in 4 patients, ie 66.6% of cases. The pure enteric form was the most frequent (3 out of 6 cases), ie 50% of cases. There was one case of intestinal necrosis. Bowel resection was performed in 6 cases, or 100%. The cause of intussusception was found in all patients, including a benign tumor cause in 66.6% of cases. The immediate postoperative follow-up was straightforward in all patients We can conclude that the acute intussusception in adults is aConclusion: rare entity that should be considered in any patient with subacute abdominal pain. And we propose that oncological resection should be carried out in all cases of intestinal intussusception without attempting reduction regardless the site of the invagination, In view of the high rate of malignancy.

Sudden death related to the gastrointestinal system in Tunisia: A 13 year autopsy study.

Sudden gastrointestinal (GI) death is an unexpecteddeath due to digestive system causes mainly found after autopsy. The literature is rich in articles that studied sudden death due to cardiac causes while sudden GI deaths remain less well-documented. We retrospectively investigated all cases of gastrointestinal death at the Department of Forensic Medicine in Tunis, over 13years (January 1, 2006 to December 31, 2018). Two hundred and eight cases were collected. The mean age of our series was 51.06±20.99years. No history of digestive disorders was reported in 78.4%, and no family history of sudden death was found in any cases. A male predominance was found in most epidemiological characteristics of the sample with a significant statistical rate in some features. Non-specific abdominal pain was the most described symptom (n=92). Perforation of GI tract was the common mechanism involved in the death of 55 cases, of which 44 were related to ulcer perforation. These ulcer perforations were statistically more reported in smokers and people suffering from schizophrenia. Intestinal obstruction was the second commonest cause of death, mainly found in the elderly. Sudden death in children was most frequently caused by acute intussusception. This study highlights that systematic study of sudden death due to GI causes might provide opportunities to identify avenues for overall health improvement.