Etiology and Management for Adult Intussusception.

, Park, Sung Won; , Kim, Hee Cheol; , Cho, Young Kyu; , Hong, Hyoun Ki; , Yu, Chang Sik; , Kim, Jin Cheon

Original Article

Journal of the Korean Society of Coloproctology 2001;17(6):304-308.

Park, Sung Won , Kim, Hee Cheol , Cho, Young Kyu , Hong, Hyoun Ki , Yu, Chang Sik , Kim, Jin Cheon

¹Colorectal Clinic, Asan Medical Center, Seoul, Korea. hckim@amc.seoul.kr
²Department of Surgery, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Intussusceptions occurring in adults are relatively rare, however, surgery is usually recommended since they frequently accompany organic lesions as predisposing factor. The purpose of this study is to analyze clinical manifestations and investigate optimal treatment principles for adult intussusception.
METHODS
Clinicopathogic manifestations of 28 adult intussusception patient were analyzied, retrospectively. The types of adult intussusception were classified as enteric and colonic types. Sex ratio was 15:13 and mean age was 52 (17-80) years.
RESULTS
CT scan was the most accurate tool for diagnosis of adult intussusception and detection of underlying causes. The types of adult intussusception were 4 jejuno-jejunal, 7 ileo-ileal, 15 ileo-cecal, and 2 colo-colic types. The pathologic lesions were identified in 23 out of 28 cases (82%). Malignancy was the cause of adult intussusception in 5 cases (45%) of enteric type and in 6 cases (35%) of colonic type intussusception. Operations were performed in 26 cases (93%) and resection without reduction was performed in 23 cases.
CONCLUSIONS
Surgical exploration without reduction may be the treatment of choice since the majority of cases have organic lesions as the etiology, with relatively frequent association of malignancies.

Key Words: Adult intussusception; Surgical management