We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Contemporary Management of Adult Intussusception: Who Needs a Resection?
- Authors
Varban, Oliver; Ardestani, Ali; Azagury, Dan; Kis, Bela; Brooks, David; Tavakkoli, Ali
- Abstract
Background: Surgical resection is often recommended in adults with intestinal intussusception (AI) because of its potential association with malignancy. We provide a contemporary algorithm for managing AI by focusing on the probability of discovering a lead point. Methods: This is a retrospective study of adult patients with computed tomography (CT)-confirmed intussusception who underwent operative management of AI between 1996 and 2011 at a single academic institution. Results: Sixty-four patients were diagnosed with AI by CT scan and then managed operatively. The incidence of colonic (CI), small bowel (SBI), and retrograde intussusception (RI) was 14, 55, and 31 %, respectively. All patients with CI had a lead point, whereas none were found among patients with RI. Some 46 % of patients with SBI had a lead point. The probability of discovering a lead point in SBI was increased by past history of malignancy (RR, 3.7, p < 0.001), a mass seen on preoperative CT scan (RR, 2.9, p = 0.005), and age over 60 years (RR, 2.2, p = 0.07). Conclusions: A pathologic lead point is likely with CI but not with RI. Patients with SBI who are over the age of 60 years and have a history of malignancy or a mass noted on CT scan have a higher likelihood of harboring a pathologic lead point.
- Subjects
INTESTINAL intussusception; COMPUTED tomography; DIAGNOSTIC imaging; SURGICAL excision; CARCINOGENESIS
- Publication
World Journal of Surgery, 2013, Vol 37, Issue 8, p1872
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1007/s00268-013-2036-3