Learning objectives
1.
To briefly review the mechanism and clinical features of intussusception in the adult
2.
To describe typical imaging findings
3.
To review the most common causes of bowel intussusception in adults according to location and describe their imaging findings.
Background
Bowel intussusception is uncommon in adults,
representing only 5% of all intussusceptions and 1% of patients with bowel obstruction.
In contrast to children,
there is a demonstrable cause in 70-90% of the situations,
most commonly a neoplasm.
Malignant lesions are more frequent in the colon,
whereas benign tumors prevail in the small bowell.
They are classified according to their location within the gastrointestinal tract (gastric,
enteroenteric,
ileocolic,
ileocecal or colocolic),
the etiology (benign,
malignant or idiopathic) and the presence of a lead point.
Intraluminal lesions...
Findings and procedure details
Intussusception may occur in any gastrointestinal segment and the imaging findings are similar regardless the location.
The most commonly used imaging methods are ultrasound and CT.
Ultrasound
In children,
ultrasound is the modality of choice,
as it has both high sensitivity and specificity,
and it is fast,
non-invasive and easy to perform.
However,
in the adult population there may be false positives due to bowel thickening secondary to conditions such as lymphoma or an inflammatory mass.
False negative results may occur if there is abundant...
Conclusion
Although intussusception is rare in adults,
it is often associated with an organic lesion,
most commonly a neoplasia.
The clinical presentation is quiet nonspecific,
often leading to delayed diagnosis.
Therefore one must be aware of this entity and its findings,
so that an early diagnosis can be made.
References
Azar T,
Berger DL.
Adult intussusception.
Ann Surg 1997; 226:134–138
Waseem M,
Rosenberg H.
Intussusception.
Pediatric Emergency Care 2008; 24,
11: 793-800
Kim,
Y et al.
Adult Intestinal Intussusception: CT Appearances and Identification of a Causative Lead Point.
RadioGraphics 2006; 26:733–744
Baleato-González S et al.
Intussusception in adults: what the radiologist should know.
Emergency Radiology 2012; 19: 89-101
Hong Shoi S et al.
Intussusception in Adults: From Stomach to Rectum.
AJR 2004; 183: 691-698.
Wool Eom,
B et al.
Gastrogastric Intussusception Secondary to a Gastric...