From the Research
Adult intussusception typically requires surgical intervention, as the majority of cases have an underlying pathology that acts as a lead point, making spontaneous resolution unlikely. In adults, about 90% of cases have an underlying pathology (such as tumors, polyps, or adhesions) that acts as a lead point, making spontaneous resolution unlikely 1. The standard approach involves surgical resection of the affected bowel segment without attempting reduction first, as reduction risks tumor seeding if malignancy is present and may cause perforation of compromised bowel.
Key Considerations
- The specific surgical technique depends on the location and suspected cause - small bowel intussusception often requires segmental resection, while colonic intussusception typically needs formal oncologic resection due to higher malignancy risk 2.
- In rare, select cases of transient or recurrent intussusception without identifiable lead point, conservative management with close monitoring might be considered, but this is the exception rather than the rule 3.
- Prompt surgical consultation is essential when adult intussusception is diagnosed to prevent complications like bowel obstruction, ischemia, and perforation 4.
Diagnostic Approach
- Computed tomography (CT) scan is the primary diagnostic modality used in the majority of cases, with abdominal pain being the predominant presenting symptom 1.
- A pathological lead point is observed in a significant percentage of patients, with a notably higher frequency of malignancy associated with colocolic intussusception 1.
Management Strategy
- Surgical management remains the cornerstone in treating adult intussusception, particularly in cases involving the colocolic type, where there is a significant risk of underlying malignancy 1.
- Attempts at reduction are generally avoided due to the potential risk of tumor dissemination, which could adversely impact patient outcomes 2.