Intussusception in Korean Adults

Lee, Sang Kuon; Park, Woo Chan; Kim, In Chul

Abstract

BACKGROUNDS: Intussusception in adults, a rare disease, constitutes approximately 5% of all intussusceptions and accounts for 5% of all cases of intestinal obstruction.
METHODS
The medical records of 21 adult patients with documented intussusception, who were treated at Catholic University Medical College from 1986 to 1997, were retrospectively analyzed, and the results were compared with those previously published in Korea and Western countries.
RESULTS
Etiologic factors were found in 86% of cases, of which 8 cases (38%) were due to malignant disease. Clinically, abdominal pain, tenderness, nausea, and vomiting were most frequently found, but were nonspecific. Correct preoperative diagnosis was made in 28% of patients, and the diagnostic methods included plain abdominal radiography, barium contrast study, abdominal ultrasonography, and abdominal CT, the latter two playing an important role in the diagnosis. Ileocolic was the most common anatomical type.
CONCLUSIONS
The surgical treatment of choice depends on the anatomical location of the lesion and on whether or not preoperative diagnosis has been made. In colonic intussusceptions primary resection without manual reduction is recommended while in enteric intussusceptions, a previous knowledge of preoperative diagnosis permits us to choose the most acceptable surgical procedure. A vigorous effort should be made, utilizing diagnostic methods, such as abdominal ultrasonography or CT, in order to make the correct preoperative diagnosis and, therefore, to help in making a correct surgical decision.