K Sandrasegaran1, K K Kopecky, A Rajesh, J Lappas. 1. Department of Radiology, Indiana University Medical Center, Suite 0279, 550 N. University Bolevard, Indianapolis, IN 46202-5253, USA. ksandras@iupui.edu
Abstract
BACKGROUND: According to the clinical literature, intestinal intussusception in adults is rare, is associated with a pathologic lead point, and is usually treated surgically. Nonobstructing small bowel intussusception has been reported as a transient finding on computed tomographic (CT) studies. METHODS: We evaluated the radiographic and clinical findings in 24 patients who were found to have 26 proximal small bowel intussusceptions on abdominal CT scans performed for a variety of indications. RESULTS: Twenty patients with intussusceptions had no evidence of small bowel obstruction. The transient and clinically insignificant nature of 22 intussusceptions in these 20 patients was proven radiologically (n = 14), surgically (n = 1), or by clinical follow-up (n = 7). These patients demonstrated a bowel-within-bowel pattern on multiple contiguous images and absence of strangulation or intestinal dilatation. No lead points were demonstrated in these patients. Three other patients had symptoms of low-grade small bowel obstruction and were treated conservatively. Extensive follow-up investigations showed no recurrence of intussusception or a lead point. One patient had high-grade obstructive intussusception with intestinal ischemia and required surgical resection of necrotic bowel. CONCLUSIONS: Proximal small bowel intussusceptions are likely to be transient and nonobstructive and unlikely to have a significant lead point.
BACKGROUND: According to the clinical literature, intestinal intussusception in adults is rare, is associated with a pathologic lead point, and is usually treated surgically. Nonobstructing small bowel intussusception has been reported as a transient finding on computed tomographic (CT) studies. METHODS: We evaluated the radiographic and clinical findings in 24 patients who were found to have 26 proximal small bowel intussusceptions on abdominal CT scans performed for a variety of indications. RESULTS: Twenty patients with intussusceptions had no evidence of small bowel obstruction. The transient and clinically insignificant nature of 22 intussusceptions in these 20 patients was proven radiologically (n = 14), surgically (n = 1), or by clinical follow-up (n = 7). These patients demonstrated a bowel-within-bowel pattern on multiple contiguous images and absence of strangulation or intestinal dilatation. No lead points were demonstrated in these patients. Three other patients had symptoms of low-grade small bowel obstruction and were treated conservatively. Extensive follow-up investigations showed no recurrence of intussusception or a lead point. One patient had high-grade obstructive intussusception with intestinal ischemia and required surgical resection of necrotic bowel. CONCLUSIONS: Proximal small bowel intussusceptions are likely to be transient and nonobstructive and unlikely to have a significant lead point.
Authors: Timothy P Plackett; Lisa C Coviello; Christina M Belnap; Kimberley J Phillips; Ronald A Gagliano; Carrie A Sims Journal: Hawaii Med J Date: 2010-02
Authors: Hwee Leong Tan; Ye Xin Koh; Mohammad Taufik; Weng Kit Lye; Brian Kim Poh Goh; Hock Soo Ong Journal: World J Surg Date: 2018-03 Impact factor: 3.352