Clin Colon Rectal Surg 2008; 21(2): 106-113
DOI: 10.1055/s-2008-1075859
© Thieme Medical Publishers

Intestinal Intussusception

Susan M. Cera1
  • 1Physicians Regional Medical Center, Medical Surgical Specialists, Naples, Florida
Further Information

Publication History

Publication Date:
29 April 2008 (online)

ABSTRACT

Intussusception is defined as the invagination of one portion of the bowel into an immediately adjacent portion. Etiology, symptoms, diagnosis, and treatment are different in the pediatric and adult populations. In the pediatric population, most cases are idiopathic and result in the common scenario of ileocolic intussusception. Factors involved in causation include anatomic features of the developing gastrointestinal tract and infectious influences. In adults, the intussusceptum is typically the result of a mucosal, intramural, or extrinsic lead point that acts as a focal area of traction pulling the proximal portion of bowel into the peristalsing distal portion. The diagnosis and management in the pediatric population is relatively standardized with nonoperative reduction via air or contrast enemas attempted first. In the adult population, intussusception presents a preoperative diagnostic challenge; although surgical intervention is mandatory, intraoperative management remains controversial.

REFERENCES

  • 1 Lloyd D A, Kenny S E. The surgical abdomen. In: Walker WA, Goulet O, Kleinman RE et al Pediatric Gastrointestinal Disease: Pathophysiology, Diagnosis, Management. 4th ed. Ontario, Canada; BC Decker 2004: 604
  • 2 Begos D G, Sandor A, Modlin I M. The diagnosis and management of adult intussusception.  Am J Surg. 1997;  173(2) 88-94
  • 3 Scheye Th, Dechelotte P, Tanguy A, Dalens B, Vanneuville G, Chazai J. Anatomical and histological study of the ileocecal valve: possible correlations with the pathogenesis of idiopathic intussusception in infants.  Surg Radiol Anat. 1983;  5(2) 83-92
  • 4 Buettcher M, Baer G, Bonhoeffer J et al.. Three-year surveillance of intussusception in children in Switzerland.  Pediatrics. 2007;  120 473-480
  • 5 Andrews N, Miller E, Waight P et al.. Does oral polio vaccine cause intussusceptions in infants? Evidence from a sequence of three self-controlled cases series studies in the United Kingdom.  Eur J Epidemiol. 2001;  17(8) 701-706
  • 6 Rao K V. Waugh's syndrome.  Indian J Pediatr. 2005;  72(1) 86
  • 7 Eisen L K, Cunningham J D, Aufses A H. Intussusception in adults: institutional review.  J Am Coll Surg. 1999;  188 390-395
  • 8 Azar T, Berger D L. Adult intussusception.  Ann Surg. 1997;  226(2) 134-138
  • 9 Takeuchi K, Tsuzuki Y, Ando T et al.. The diagnosis and treatment of adult intussusception.  J Clin Gastroenterol. 2003;  36(1) 18-21
  • 10 Erkan N, Haciyanh M, Yildirim M, Sayhan H, Vardar E, Polat A F. Intussusception in adults.  Int J Colorectal Dis. 2005;  20 452-456
  • 11 Barussaud M, Regenet N, Briennon X et al.. Clinical spectrum and surgical approach of adult intussusception.  Int J Colorectal Dis. 2006;  21 834-839
  • 12 Goh B KP, Quah H M, Chow P KH et al.. Predictive factors of malignancy in adults with intussusception.  World J Surg. 2006;  30 1300-1304
  • 13 Zubaidi A, Al-Saif F, Silverman R. Adult intussusception: a retrospective review.  Dis Colon Rectum. 2006;  49(10) 1546-1551
  • 14 Wang L-T, Wu C C, Yu J C, Hsiao C W, Hsu C C, Jao S W. Clinical entity and treatment strategies for adult intussusceptions: 20 years' experience.  Dis Colon Rectum. 2007;  50 1941-1949
  • 15 Shub H A, Rubin R J, Salvati E P. Intussusception complicating intestinal intubation with a long Cantor tube: Report of 4 cases.  Dis Colon Rectum. 1978;  21(2) 130-134
  • 16 VanderKolk W E, Snyder C A, Figg D M. Cecal-colic adult intussusception as a cause of intestinal obstruction in Central Africa.  World J Surg. 1996;  20 341-344
  • 17 West K W, Stephens B, Vane D W, Grosfeld J L. Intussusception: current management in infants and children.  Surgery. 1987;  102 704-710
  • 18 Nagorney D M, Sarr M G, McIlrath D C. Surgical management of intussusception in the adult.  Ann Surg. 1981;  193 230-236
  • 19 Daneman A, Alton D J. Intussusception issues and controversies related to diagnosis and reduction.  Radiol Clin North Am. 1996;  34 743-756
  • 20 Boyle M J, Arkell L J, Williams J T. Ultrasound diagnosis of adult intussusception.  Am J Gastroenterol. 1993;  88 617-618
  • 21 Cotlar A M, Cohn I. Intussusception in adults.  Am J Surg. 1961;  101 114-120
  • 22 Sorantin E, Lindbichler F. Management of intussusception.  Eur Radiol. 2004;  14(Suppl 4) L146-L154
  • 23 Schwartz S I, Fischer J E, Spenser F C, Shires G T, Daly J M. Principles of Surgery. 7th ed. New York; McGraw-Hill 1998
  • 24 Guo J Z, Ma X Y, Zhou Q H. Results of air pressure enema reduction of intussusception: 6396 cases in 13 years.  J Pediatr Surg. 1986;  21 1201-1203
  • 25 Maote K, Beasley S W. Perforation during gas reduction of intussusception.  Pediatr Surg Int. 1998;  14 168-170
  • 26 Weilbaecher D, Bolin J A, Hearn D, Ogden W. Intussusception in adults: Review of 160 cases.  Am J Surg. 1971;  121 531-534

Susan M CeraM.D. 

Physicians Regional Medical Center, Medical Surgical Specialists

6101 Pine Ridge Rd., Naples, FL 34119

Email: susan.cera@pmc.hma.org

    >