Mohamed Tarchouli1,2, Abdelmounaim Ait Ali3,4. 1. Department of Surgery, First Medical and Surgical Center, Agadir, Morocco. 2. Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco. 3. Department of Visceral Surgery, Mohammed V Military Hospital, Rabat, Morocco. 4. Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Abstract
INTRODUCTION: Intussusception is a rare condition in adults. A pathological lesion is usually found with a significant percentage of malignancy. The optimal treatment is still not universally clear. METHODS: This is a retrospective review of adult patients with a diagnosis of intestinal intussusception and surgically treated at our institution from January 2009 to December 2018. Clinical, operative, and histological details were collected and analyzed. RESULTS: A total of 26 cases, 16 males and 10 females, were diagnosed with surgically proven intussusception during the 10-year period. The mean age was 45 years (range 21-70). Using ultrasound and/or computed tomography as imaging study, the preoperative diagnosis was made in 21/26 (81%) patients. Five intussusceptions were discovered only upon exploratory laparotomy for intestinal obstruction. There were 19 (73%) cases of enteric and 7 (27%) cases of colonic intussusceptions. All patients underwent surgical exploration. Intestinal resection with immediate anastomosis was the technique of choice for most patients. A single patient underwent stoma for peritonitis secondary to intestinal perforation. An organic cause has been systematically revealed, and no idiopathic intussusception was detected. Etiology was malignant in 9 (35%) cases. CONCLUSION: Adult intussusception should be considered in any patient with subacute abdominal pain. Considering the high rate of malignancy, intestinal resection without attempting reduction is highly recommended for colonic intussusceptions. However, a more selective approach can be adopted for enteric intussusceptions.
INTRODUCTION: Intussusception is a rare condition in adults. A pathological lesion is usually found with a significant percentage of malignancy. The optimal treatment is still not universally clear. METHODS: This is a retrospective review of adult patients with a diagnosis of intestinal intussusception and surgically treated at our institution from January 2009 to December 2018. Clinical, operative, and histological details were collected and analyzed. RESULTS: A total of 26 cases, 16 males and 10 females, were diagnosed with surgically proven intussusception during the 10-year period. The mean age was 45 years (range 21-70). Using ultrasound and/or computed tomography as imaging study, the preoperative diagnosis was made in 21/26 (81%) patients. Five intussusceptions were discovered only upon exploratory laparotomy for intestinal obstruction. There were 19 (73%) cases of enteric and 7 (27%) cases of colonic intussusceptions. All patients underwent surgical exploration. Intestinal resection with immediate anastomosis was the technique of choice for most patients. A single patient underwent stoma for peritonitis secondary to intestinal perforation. An organic cause has been systematically revealed, and no idiopathic intussusception was detected. Etiology was malignant in 9 (35%) cases. CONCLUSION: Adult intussusception should be considered in any patient with subacute abdominal pain. Considering the high rate of malignancy, intestinal resection without attempting reduction is highly recommended for colonic intussusceptions. However, a more selective approach can be adopted for enteric intussusceptions.
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