ISSN: 2734-3138 E-ISSN: 2971-625X

Orient Journal of Surgical Sciences

The official Publication of the Department of Surgery
Chukwuemeka Odumegwu Ojukwu University Teaching Hospital
Awka Anambra State Nigeria
ADULT INTUSSUSCEPTION: CURRENT PERSPECTIVE
Orient Journal of Surgical Sciences
Vol 2[1] Jan - Dec, 2021

original article

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ADULT INTUSSUSCEPTION: CURRENT PERSPECTIVE


Mbah N (FRCS Ed., FWACS; FACS)
Department of Surgery,
Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH),
Awka, Anambra State, Nigeria.

Correspondence to: Dr. Mbah N.
E-mail: nonsodr@yahoo.co.uk

Citation: Mbah N. Adult intussusception: Current perspective.
Orient Journal of Surgical Sciences.
January - December 2021: Page 1 - 13


ABSTRACT
Intussusception, the invagination of a segment of the bowel into the lumen of a contiguous segment, is an uncommon cause of abdominal pain and bowel obstruction in adults. Due to the often incomplete nature of the obstruction, presentation in the adult patient may be delayed and the diagnosis is either missed or made at exploratory laparotomy in regions where sophisticated imaging facilities such as computed tomography (CT) scan are not readily affordable or available. A high index of suspicion is required for the
earlier detection of this condition in the adult patient for prompt and successful surgical intervention.

Key words: Adult Intussusception, Abdominal Pain, Incomplete Obstruction, Index of Suspicion, Late Diagnosis.


INTRODUCTION

Intussusception, derived from Latin words intus (within) + sus-cipio (to take up) is the clinical condition involving the invagination of a bowel segment (Intussusceptum) into the lumen of the immediate adjoining part (Intussuscipiens).1      

The direction of the slide is commonly distal (antegrade) but may be retrograde in rare cases. Intussusception or “introsusception” as it was previously called, was first described by Paul Barbette of Amsterdam in 1674.2  Cornelius Velse recorded the first successful laparotomy for adult intussusception.3 In 1789, John Hunter described the post mortem pathology.4

            The aetiology, clinical features and management of paediatric intussusception are quite different from the adult disease (table 1)

Adult intussusception (AI) is an infrequent cause of abdominal pain and intestinal obstruction. The clinical symptoms may be acute, sub acute or chronic.5,6 Most cases present with incomplete bowel obstruction.

Unlike childhood intussusception which is classically characterized by the triad of colicky abdominal pain, presence of a palpable abdominal lump and the passage of


red currant jelly stool, the abdominal pain of the adult disease is often nonspecific and elusive.7

            Therefore, the diagnosis can be challenging as the intermittent abdominal pain which is the main symptom often settles comparatively quickly. Clinical examination and routine investigations are often negative and these patients will probably be labeled as having peptic ulcer disease or any of the other numerous differentials.8 These factors account for the often missed diagnosis which characterize AI. Multi-Detector Computed




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