Intussusception in adults Moamen Salameh 1. Intussusception Intussusception of the bowel is defined...
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Transcript of Intussusception in adults Moamen Salameh 1. Intussusception Intussusception of the bowel is defined...
Intussusception
Intussusception of the bowel is defined as the telescoping of a proximal segment of the gastrointestinal tract within the lumen of the adjacent segment
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• A rare condition in adults, accounting 5% of all cases of intussusception and 1-5% of bowel obstructions
• Symptoms are often chronic, with intermittent abdominal pain as the main symptom
• Types: enteroenteric, enterocolic, colocolic
• Arises in the small bowl in two-thirds of cases
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Secondary intuss.
• Initiates from any pathologic lesion of the bowel wall or irritant within the lumen
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Aetiology - Small bowl
• Benign lesions - neoplasm (lipoma, leiomyoma, haemangioma, neurofibroma)
• Adhesions
• IBD
• Meckel’s diverticulum
• Coeliac disease
• Henich-schonlein purpura
• Iatrogenic
• Malignant - most often metastatic 15%
• Idiopathic 20%
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Aetiology - Large bowl
• malignant 65%
• Benign: neoplasm (lipoma, leiomyoma, adenomatous polyps)
• IBD
• Endometriosis
• Idiopathic 10%
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Clinical presentation• The classic paediatric presentation of acute
intussusception is rare in adults
• The majority of cases in adults are presented as chronic non-specific symptoms
• Physical examination may demonstrate diffuse or localised abdominal tenderness, but is often unremarkable
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Symptoms• Nausea
• Vomiting
• Gastrointestinal bleeding
• Changes in bowl habits
• Constipation
• Diarrhoea
• Abdominal distention
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