Munir Ahmad Rathore.
Adult Intussusception - An experience with 4 patients over 10 years.
Ann King Edward Med Uni Jan ;9(2):133-6.

The rare adult Intussusception accounts for only a very small fraction of causes of intestinal obstruction. The aim of this study is to review of an experience with Intussusception in the adult. The author encountered 4 cases of adult Intussusception (AI) over a 10-year period (1992-2002). M:F ratio was 1:1. Mean age was 47y. Small bowel obstruction was documented in all. They were investigated by random investigation including radiographs, ultrasound exam, barium studies, endoscopy and CT scan. All however were diagnosed at operation although some pre-operative suspicion was raised in two cases. All had a laparotomy. Two were ileo-ileal and two ileo-caecal AI. One was chronic AI and three sub-acute. One Intussusception had a malignancy (lymphoma) as a lead point. Two had a submucous lipoma at the apex. In an interesting case the suture knot from a recent small bowel anastomosis (2-3 weeks prior) was forming the lead point of the Intussusception! The 2 ileo-ileal AI had segmental resection. Right hemicolectomy was done for the 2 ileo-caecal AI. "Target lesion" and leumen-within-leumen were the CT hallmarks on review. Retrospective barium enema review failed to show the Intussusception. This may suggest the Intussusception may have been intermittent. All 4 recovered uneventfully and remained well. One patient was referred for chemotherapy for intestinal lymphoma. Adult Intussusception remains a rare cause of abdominal pain. The treatment almost always is surgical.

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