Keywords:
Obstruction / Occlusion, Acute, Surgery, Audit and standards, CT, Small bowel, Gastrointestinal tract, Abdomen
Authors:
C. H. H. Little1, C. M. Cameron2, M. A. Hunter2; 1Glasgow, Glasgow/UK, 2Glasgow/UK
DOI:
10.26044/ecr2019/C-2283
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 were enteroenteric (51%),
a finding supported in the literature [6].
A significant number of CT identified intussusceptions were deemed incidental and managed conservatively with follow up imaging or clinical review confirming resolution.
These were more likely to be entero-enteric with no features on CT to suggest lead-point,
obstruction or ischaemia.
The PPV in this subgroup was 100%.
Along with clinical review therefore,
we conclude that these CT characteristics can be used to accurately identify a cohort of likely transient and incidental intussusceptions that do not require an operation therefore avoiding unnecessary surgery.