Adult intussusception: Is associated bowel gangrene common.
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Date
2011-01
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Abstract
Introduction: Adult intussusception is a rare clinical entity in contrast to pediatric
intussusception. Varied and non-specific clinical features, delayed presentation, and lack of awareness among attending surgeons to consider it as differential diagnosis complicates the clinical course of the disease.
Methods: A retrospective study was conducted in a tertiary care teaching hospital in north
India. Nine adult patients who presented with intussusception over a period of six years were
analyzed. Their clinical profile, management and underlying pathology were studied.
Results: Five out of nine patients had acute presentation while remaining four presented with
subacute/chronic symptoms. Median duration of presentation was 8 days (range 2-180 days).
Clinical diagnosis of intussusception was considered in only one patient. Ultrasonography
clinched the diagnosis in all four patients who presented with subacute/chronic symptoms.
Ileo-ileal intussusception was present in five patients, with one having associated jejunojejunal
intussusception. Other four patients had ileo-colic intussusception. Seven of the 9
patients (77%) were found to have associated bowel gangrene. Resection of the bowel segment
having intussusception was done in all patients. Five patients had associated benign intestinal
pathology while idiopathic intussusception was present in four patients.
Conclusion: The patients presented in the series are distinct from cases reported earlier in
literature in term of late presentation, manifesting as acute intestinal obstruction, high frequency
of associated intestinal gangrene, and absence of associated intestinal malignancy. Patients
presenting with features of intestinal obstruction and abdominal lump should be subjected to
urgent imaging studies to examine the possibility of intussusception. The high frequency of
bowel gangrene encountered in patients of adult intussusception mandates prompt surgical intervention soon after diagnosis.
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Keywords
intussusception, intestinal gangrene, intestinal obstruction
Citation
Prasad Dharmendra, Mohanty Debajyoti, Garg Pankaj Kumar, Agarwal Vivek, Jain Bhupendra Kumar. Adult intussusception: Is associated bowel gangrene common. Tropical Gastroenterology. 2011 Jan-Mar; 32(1): 45-49.