Small-bowel intussusceptions in adults detected on CT: Determination of the clinical significance using CT findings, laboratory values, and clinical parameters.

PURPOSE: Evaluation of clinical findings, CT findings, or laboratory findings is helpful to differentiate between small bowel intussusceptions requiring surgery and those that are self-limiting.

MATERIALS AND

METHODS

Retrospective analysis of abdominal CT scans in adult patients using free text search with the terms "intussusception" and "invagination", followed by review of the image files to check for the presence of an intussusception. Evaluation of the resulting 112 adult patients (male/female, 81/31; mean age, 47±17 y) with a total of 145 small bowel intussusceptions noted on CT images. The appearance, number, type (enteroenteric versus enterocolic), length, maximum short-axis diameter of intussusceptions, and presence of small bowel obstruction (short-axis diameter of proximal small bowel >3cm) were noted. The outcome was defined as surgical (complicated) or self-limiting (uncomplicated). Associations between complicated and uncomplicated intussusceptions in relation to laboratory and imaging findings were analyzed.

RESULTS

There were 128/145 (88%) enteroenteric and 17/145 (12%) enterocolic intussusceptions. 17/145 intussusceptions (12%) in 17/112 (15%) patients required surgical therapy and were considered complicated with 8 of them (47%) having an underlying neoplasia. Length (p<0.001), diameter (p<0.001), and type (p=0.031) of intussusception as well as the presence of vessels (p=0.021) within an intussusception on CT scan, clinical symptoms (p=0.003), and signs of bowel obstruction (p<0.001) were associated with a surgical outcome.

CONCLUSION

Clinical symptoms, signs of bowel obstruction, type, length, and diameter of intussusception, and a visible tumor within an intussusception on a CT scan were critical signs of complicated intussusception, i.e., the necessity for surgical treatment.

KEY POINTS: · Most small bowel intussusceptions detected on CT scan are self-limiting.. · CT findings of invagination can help to distinguish between those intussusceptions requiring surgical therapy and those that are self-limiting.. · Additional evaluation of the patient's clinical findings is crucial..

CITATION FORMAT: · Georgieva M, Rennert J, Baeumler W et al. Small-bowel intussusceptions in adults detected on CT: Determination of the clinical significance using CT findings, laboratory values, and clinical parameters. Rofo 2026; 10.1055/a-2819-4412.