Adult intussusception: Presentation, management, and outcomes of 148 patients

Rachel A. Lindor, M. Fernanda Bellolio, Annie T. Sadosty, Frank Earnest IV, Daniel Cabrera

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Background: Intussusception is a predominantly pediatric diagnosis that is not well characterized among adults. Undiagnosed cases can result in significant morbidity, making early recognition important for clinicians. Study Objectives: We describe the presentation, clinical management, disposition, and outcome of adult patients diagnosed with intussusception during a 13-year period. Methods: A retrospective study of consecutive adult patients diagnosed with intussusception at a tertiary academic center was carried out from 1996 to 2008. Cases were identified using International Classification of Diseases, 9 th Revision codes and a document search engine. Data were abstracted in duplicate by two independent authors. Results: Among 148 patients included in the study, the most common symptoms at presentation were abdominal pain (72%), nausea (49%), and vomiting (36%). Twenty percent were asymptomatic. Sixty percent of cases had an identifiable lead point. Patients presenting to the emergency department (ED) (31%) had higher rates of abdominal pain (relative risk [RR] 5.7) and vomiting (RR 3.4), and were more likely to undergo surgical intervention (RR 1.8) than patients diagnosed elsewhere. There were 77 patients who underwent surgery within 1 month; patients presenting with abdominal pain (RR 2.2), nausea (RR 1.7), vomiting (RR 1.4), and bloody stool (RR 1.9) were more likely to undergo surgery. Conclusions: Adult intussusception commonly presents with abdominal pain, nausea, and vomiting; however, approximately 20% of cases are asymptomatic and seem to be diagnosed by incidental radiologic findings. Patients presenting to an ED with intussusception due to a mass as a lead point or in an ileocolonic location are likely to undergo surgical intervention.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalJournal of Emergency Medicine
Volume43
Issue number1
DOIs
StatePublished - Jul 1 2012

Keywords

  • abdominal pain
  • intussusception
  • management
  • obstruction
  • surgery

ASJC Scopus subject areas

  • Emergency Medicine

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