II. Epidemiology
-
Incidence in adults: 0.05 to 0.08% of Intussception cases
- Most intussception occurs in under age 4 years
III. Findings: Presentations
- See Inussusception
- Adult Intussusception is typically found on CT Abdomen during the evaluation for Abdominal Pain
IV. Imaging
- See Intussusception (almost exclusively diagnosed on Ultrasound in children)
-
CT Abdomen findings (regardless of contrast)
- Target Sign (concentric rings of bowel within bowel)
- Proximal Small Bowel may be dilated >2.5 to 3 cm when obstruction is present
- Enteroenteric Intussusception (Small Bowel within Small Bowel) is most common
V. Causes
- Malignancy (16% to 65% of adult cases)
- Inflammatory Bowel Disease
- Meckel's Diverticulum
- Postoperative Feeding Tubes
- Intraluminal device (e.g. Feeding Tube)
VI. Management
- Surgical reduction wih possible bowel segment resection
- Often performed in adults due to high rates of associated malignancy
- Adult Intussusception is more proximal than children and less likely to respond to air-contrast enema
- Findings associated with benign cause and spontaneous reduction
- Intussusception <3.5 cm long
- Narrow diameter without obstruction (<2.5 cm diameter)
- Lyoff (2003) Radiology 227(1): 68-72 [PubMed]
VII. References
- Broder (2018) Crit Dec Emerg Med 32(8): 16-7
- Marinis (2009) World J Gastroenterol 15(4): 407-11 [PubMed]