Surgery Book

Stomach Disorders

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Adult Intussusception

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

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