Intussusception as a cause of bowel obstruction in adults.

BACKGROUND

Due to its unspecific presentation, intussusception is often diagnosed with delay in adults.

METHODS

From 1986 to 2002, ten patients (men/women: 8/2, median age: 53.6 years) were managed for intussusception. Clinical, radiological and surgical management data were retrospectively analyzed.

RESULTS

All patients presented with abdominal symptoms (pain: 10/10, nausea and vomiting: 3/10, diarrhoea: 2/10, "red-currant jelly stool": 2/10) during a median time of 8.3 months (2 days - 6 years) and with a trend for longer duration of symptoms for benign compared to malignant underlying disease (2 years vs 1 month). Two cases had developed acute bowel obstruction at the time of surgery. CT-scan was always performed, with correct diagnosis in seven cases. Ultrasonography (4/10), contrast enema (5/10) or coloscopy (4/10) either missed the intussusception or served merely to confirm the CT diagnosis. At surgery, an underlying lesion (six malignant and four benign tumours) was identified and removed in all cases (four small bowel, three right colon, two ileocaecal and one left colon resections). Eight were undiagnosed previously.

CONCLUSIONS

Intussusception is rare in adults, but should be considered in cases of chronic or acute bowel obstructions. Early surgical management allows detection and potential cure of underlying tumours.