I Goutos1, A W O'Sullivan, F Myint. 1. Department of Surgery, North Middlesex University Hospital, Sterling Way, London N18 1QX, UK. ioannisgoutos@hotmail.com
Abstract
BACKGROUND: Intussusception is a common surgical diagnosis in the paediatric population and is most commonly idiopathic. In adults a substantial proportion of patients have a malignant leading cause and surgical intervention is mandatory. Intussusception involving the small bowel is thought to be more likely benign in nature and is frequently reduced before the leading cause is excised. AIM: Review of the literature to determine the incidence of malignancy in small bowel intussusceptions and discussion of the optimal operative strategy. METHODS: We describe an unusual case of adult idiopathic jejunal intussusception, which was treated with excision without reduction and present the results of a relevant literature search. RESULTS: A number of reports have confirmed a high incidence of malignancy in small bowel intussusceptions and consequently excision without reduction should be undertaken. CONCLUSION: It is in the authors' view that excision without reduction should be the treatment of choice in small bowel intussusception unless preoperative imaging delineates benign leading pathology and in the rare occasion of a shortened gut.
BACKGROUND: Intussusception is a common surgical diagnosis in the paediatric population and is most commonly idiopathic. In adults a substantial proportion of patients have a malignant leading cause and surgical intervention is mandatory. Intussusception involving the small bowel is thought to be more likely benign in nature and is frequently reduced before the leading cause is excised. AIM: Review of the literature to determine the incidence of malignancy in small bowel intussusceptions and discussion of the optimal operative strategy. METHODS: We describe an unusual case of adult idiopathic jejunal intussusception, which was treated with excision without reduction and present the results of a relevant literature search. RESULTS: A number of reports have confirmed a high incidence of malignancy in small bowel intussusceptions and consequently excision without reduction should be undertaken. CONCLUSION: It is in the authors' view that excision without reduction should be the treatment of choice in small bowel intussusception unless preoperative imaging delineates benign leading pathology and in the rare occasion of a shortened gut.