Adult intussusception: 10-year experience in two Belgian centres

Background: adult intussusception is a rare entity with a different clinical presentation and aetiology than in children. Objective: To provide a comprehensive overview of the clinical presentation, aetiology, diagnosis and management of adult intussusception Methods: We review 43 cases with a preoperative diagnosis of symptomatic gastrointestinal adult intussusception. Results: In 67% of the cases an underlying lead point was discovered. Most intussusceptions were of the enteric type (65%) with a predominant benign or idiopathic origin. Malignancy was present in half of the cases with a colonic lead point. CT was the preferred imaging technique (81%) with a sensitivity of 94%. Colonoscopy provided the correct diagnosis in 89% of the cases involving a colonic lead point. Surgical intervention occurred in 72% of the cases. Conclusion: The combination of low incidence and non-specific symptoms makes intussusception in the adult difficult to diagnose. Modern imaging techniques often provide the correct preoperative diagnosis. A culprit lesion is usually identified after a careful search. Suspicion for a malignant lead point should be high in case of colonic involvement and colonoscopy can be of added value in these cases. The therapeutic strategy depends on several variables and requires for a patient-tailored approach mostly involving surgery. (Acta gastroenterol. belg., 2016, 79, 301-308).