Adult Intussusception

1. Adult Intussusception Primarily dz of childhood Infrequently seen in adults 5% of all intussusceptions occur in adults Account for ~ 5% of SBO in adults

7. Etiology Children � 90 % idiopathic (adenovirus � enlargement of Peyers patches) Adults � 90 % due to identifiable lesion (neoplasm) Common location � jxns btw/ freely moving segments & fixed segments (retroperitoneal � ileocecal)

8. Adult Intussusception Majority occur in small bowel � predominantly caused by benign neoplasms In large bowel � lead point often is malignant etiology Other possibilities � appendix; AIDS pts

9. Presentation Nonspecific chronic / subacute symptoms related to intermittent PSBO More acute � intermittent pain / BRBPR

10. Diagnosis Since symptomatology varies � difficult to diagnosis to make preoperatively AXR � �air crescent� � intraluminal air trapped btwn walls Barium � �coiled spring� � contrast in compressed lumen Ultrasound � target or doughnut sign CT � target sign or appears as a mass lesion

11. Barium Enema

12. Diagnosis Since symptomatology varies � difficult to diagnosis to make preoperatively AXR � �air crescent� � intraluminal air trapped btwn walls Barium � �coiled spring� � contrast in compressed lumen Ultrasound � target or doughnut sign CT � target sign or appears as a mass lesion

15. Treatment Predominantly surgery � reduction / resection