2000, Number 3
PDF size: 159.79 Kb.
ABSTRACTObjective: To present and analyze seven cases of intussusception in adult patients.
Setting: Third level health care hospital.
Design: Retrospective, observational study.
Patients and methods: We reviewed the clinical histories of 279 patients that had been subjected to exploratory laparotomy. All patients had a preoperative diagnosis of intestinal obstruction for a 10 year period. We included only those patients with confirmed intussusception, and analyzed the following variables: age, gender, clinical symptoms, etiology, diagnostic studies, treatment, days of hospital stay, morbidity, and mortality.
Results: From the 279 patients, 7 (2.1%) corresponded to intussusception, with an average age of 45 years (range 30 to 67), four were men and three were women. Most frequent symptoms at the time of admission were: abdominal pain in six, abdominal distension in five, constipation and anorexia in four, and vomiting in three. Preoperative diagnosis had only been made in three (43%). Etiology could be established in six of the seven patients (85%), of whom three corresponded to neoplasms. Intestinal resection and primary anastomosis was performed in five patients, rectopexy in two, and reduction of the intussusception was performed in only one patient. Two patients presented complications, one of them died due to pneumonia and sepsis. Average hospital stay was of 16.8 days (from 4 to 71).
Conclusion: Intussusception is a rare clinical entity in adults. It is frequently associated to neoplasms of the digestive tract. Its treatment is surgical and consists of resecting the involved intestinal segment.
Begos DG, Sandor A, Modlin IM. The diagnosis and management of adult intussusception. Am J Surg 1997; 173: 88-94.
Azar T, Beger DL. Adult intussusception. Ann Surg 1997; 226: 134-8.
Reijnen HA, Joosten HJ, de Boer HH. Diagnosis and treatment of adult intussusception. Am J Surg 1989; 158: 25-8.
Stubenbord WT, Thorbjarnarson B. Intussusception in adults. Ann Surg 1970; 172: 306-10.
Guerra VJ, Lee BY. Intussusception in adults. Contemporary Surg for Residents 1994; 2: 7-11.
Weilbaecher D, Bolin JA, Hearn D, Ogden W 2d. Intussusception in adults. Review of 160 cases. Am J Surg 1971; 121: 531-5.
Prater JM, Olshemski FC. Adult intussusception. Am Fam Physician 1993; 47: 447-52.
Donhauser JL, Kelly EC. Intussusception in the adult. Am J Surg 1950; 79: 673-7.
Sanders GB, Hagan WH, Kinnaird DW. Adult intussusception and carcinoma of the colon. Ann Surg 1958; 147: 796-803;discussion 803-4.
Nagorney DM, Sarr MG, McIlrath DC. Surgical management of intussusception in the adult. Ann Surg 1981; 193: 230-6.
Weissberg DL, Scheible W, Leopold GR. Ultrasonographic appearance of adult intussusception. Radiology 1977; 124: 791-2.
Wiot JF, Spitz HB. Small bowel intussusception demonstrated by oral barium. Radiology 1970; 97: 361-6.
Iko BO, Teal JS, Siram SM, Chinwuba CE, Roux VJ, Scott VF. Computed tomography of adult colonic intussusception: clinical and experimental studies. Am J Roentgenol 1984; 143: 769-72.
Agha FP. Intussusception in adults. Am J Roentgenol 1986; 146: 527-31.
Parienty RA, Lepreux JF, Gruson B. Sonographic and CT features of ileocolic intussusception. Am J Roentgenol 1981; 136: 608-10.
Duszynski DO, Anthone R. Jejunal intussusception demonstrated by Tc99m pertechnetate and abdominal scanning. Am J Roentgenol Radium Ther Nucl Med 1970; 109: 729-32.
Sadahiro S, Ohmura T, Yamada Y, Saito T, Akatsuka S. A case of cecocolic intussusception with complete invagination and intussusception of the appendix with villous adenoma. Dis Colon Rectum 1991; 34: 85-8.
Felix EL, Cohen MH, Bernstein AD, Schwartz JH. Adult intussusception; case report of recurrent intussusception and review of the literature. Am J Surg 1976; 131: 758-61.
Sarr MG, Nagorney DM, McIlrath DC. Postoperative intussusception in the adult: a previously unrecognized entity? Arch Surg 1981; 116: 144-8.
Cox JA, Martin LW. Postoperative intussusception. Arch Surg 1973; 106: 263-6.
Duncan A, Phillips TF, Sclafani SJ, Goldstein AS, Lipkowitz G, Scalea TM, et al. Intussusception following abdominal trauma. J Trauma 1987; 27: 1193-9.
Hengster P, Pernthaler H. Enteric intussusceptions after a road traffic accident in a 19 year old girl. Eur J Surg 1993; 159: 311-2.
Berne JD, Asensio JA, Gomez H, Chahwan S, Falabella A. Double intussusception in an adult following a laparotomy for trauma: a case report and review of the literature. Am Surg 1998; 64: 781-4.
Stewardson RH, Bombeck CT, Nyhus LM. Critical operative management of small bowel obstruction. Ann Surg 1978; 187: 189-93.