Intestinal intussusceptionin adult patients is a rare entity. Differently from pediatric patients, thiscondition is often secondary to a defined lesion. A significant percentage ofthese lesions are malignant. Therefore, an optimal treatment is necessary tothis condition. The aim of this study is to determine causes and managementof adult intussusception. We carried out a retrospective review of adults patientswith diagnosis of intussusception from 1997 to 2007 in our institution. Detailsconcerning presentation, diagnosis, management, and pathology were analyzed.Sixteen patients with intestinal intussusception underwent laparotomy. Therewere 10 women with median age of 49 years (range, 19-76). Abdominal pain wasthe most common clinical finding. Seven patients (46.6%) presented with acutesymptoms, six caused by intestinal obstruction. Diagnosis of gastrointestinalintussusception was correctly done preoperatively in 8 patients (50%). Fivepatients (31.25%) had the lead point of the intussusception in the small bowel,two in the jejunum and three in the ileum. Six patients (37.5%) had the leadpoint in the ileocecal valve resulting in ileocolic intussusception and fivepatients (31.25%) had colonic leading points. An anatomic or pathologic causeof the intussusception was identified in 14 patients (87.5%). In two patients(12.5%) the intussusception occurred in the postoperative period without associatedlesions. Malignant neoplasms accounted for eight of sixteen patients (50%).All patients underwent operative management. The two patients who have postoperativeintussusception of the small bowel underwent reduction with no resection. Theothers three patients with small bowel intussusception underwent to enterectomy.Right hemicolectomy was performed in five of the six patients with ileo-colonicintussusception. Retossigmidectomy was performed in one of the two patientswith sigmoid intussusception. Hartmann's procedure was performed in two patients.Subtotal colectomy with ileorectal anastomosis and ileostomy was performed inone patient with colo-colonic intussusception. Minor postoperative complicationsoccurred in 3 patients. Although uncommon, surgeons need to be aware about epidemiologyand treatment options for adult intussusception. The symptoms and signs areoften non-specific and the surgeon might be faced with the diagnosis only atlaparotomy. Surgical resection is indicated in most of the cases due to thepossibility of malignant lesion as cause of intussusception.
