VA Intern Report Pearl 3.24 Adult Intussusception

Just wanted to share a couple of pearls about this condition which is not commonly seen in adults!

 

1. Intussusception is a rare condition in adults, and accounts for 1-3% of bowel obstruction.

 

2. You find a cause in about 70-90% of cases and of those, about 40% are caused by a primary tumor or a met

 

3. They are often found by CT but the classic triad in adults for intussusception is abdominal pain, palpable sausage-shaped mass, and heme-positive stools.

 

4. The best treatment is a matter of controversy! Most surgeons think that surgery is mandatory because it increases the likelihood of identifying a cause, which is often cancer, especially in patients over the age of 60. In some cases of small bowel intussusception, operative reduction can be attempted before resection if you really don’t think the cause is cancer but resection is often chosen even if the cause is benign because it will tend to recur!

 

Takeuchi, et al. The Diagnosis and Treatment of Adult Intussusception. Journal of Clinical Gastroenterology. 36(1):18-21, January 2003.

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