Aims and objectives
The detection of intussusception is increasing both with technological advancements in multi-detector CT and with its increasing use in abdominal imaging.
In particular,
there have been increasing numbers of non-lead point intussusceptions that may be transient and therefore not require surgical intervention [1].
Determining the clinical significance of such a finding can be a diagnostic challenge.
Intussusception has a classic bowel within bowel appearance on CT with invagination of a segment of the gastrointestinal tract (intussusceptum) into an adjacent segment (intussuscipiens).
The mesentery and mesenteric...
Methods and materials
A search of our picture archiving and communication system (PACS) records of CT reports on adults (18 or older) within Greater Glasgow and Clyde health board revealed 202 patients with intussusception included in the report over a 4 year period from January 2014 to December 2017.
These were retrospectively identified using a combination of key word search of CT reports and image review.
On subsequent image analysis,
177 of these cases had imaging appearances consistent with intussusception.
The multiplanar images were reviewed and imaging characteristics...
Results
The total number of CT scans of the abdomen and pelvis performed within the Greater Glasgow and Clyde Health Board over the 4 year period analysed was 65,393 giving an overall incidence of intussusception of under 0.3%,
comparable to that documented in the literature [3,4,5].
Overall,
the majority were enteroenteric 91/177 (51%),
followed by colocolic 53/177 (30%) and ileocolic 30/177 (17%),
Table 1.
Of the 177 intussusceptions identified on CT,
a lead point was identified in 67/177 (38%).
There was no lead point in 110...
Conclusion
Intussusception in adults was a rare finding in our study however,
contrary to the findings of some previous reports [4],
management need not always be surgical and adult intussusception was not associated with a lead point in the majority of cases.
However,
CT was specific at predicting lead-point intussusception with a high positive predictive value in those requiring surgery and it is therefore a useful diagnostic tool and an accurate predictor of patients who would benefit from surgery.
In our study,
the majority of intussusceptions...
Personal information
Dr.
Cariss H H Little - Radiology registrar,
Queen Elizabeth University Hospital,
Glasgow,
Scotland,
U.K.
Email :
[email protected]
Dr.
Caroline M Cameron -Radiology consultant,
Royal Alexandra Hospital,
Paisley,
Glasgow,
Scotland,
U.K.
Email:
[email protected]
Dr.
Mark A Hunter - Radiology consultant,
Royal Alexandra Hospital,
Paisley,
Glasgow,
Scotland,
U.K.
Email:
[email protected]
References
[1] Onkendi,
E.O.,
Grotz,
T.E.,
Murray,
J.A.
and Donohue,
J.H.,
2011.
Adult intussusception in the last 25 years of modern imaging: is surgery still indicated?.
Journal of Gastrointestinal Surgery,
15(10),
p.1699.
[2] Kim,
Y.H.,
Blake,
M.A.,
Harisinghani,
M.G.,
Archer-Arroyo,
K.,
Hahn,
P.F.,
Pitman,
M.B.
and Mueller,
P.R.,
2006.
Adult intestinal intussusception: CT appearances and identification of a causative lead point.
Radiographics,
26(3),
pp.733-744.
[3] Rea,
J.D.,
Lockhart,
M.E.,
Yarbrough,
D.E.,
Leeth,
R.R.,
Bledsoe,
S.E.
and Clements,
R.H.,
2007.
Approach to management of intussusception in adults:...
