Tumor spectrum of adult intussusception

Abstract

Introduction: Adult intussusception is rare. Most general and colorectal surgeons are unfamiliar with its etiology and optimal management.

Patients and methods: Patients older than 16 years and diagnosed with intestinal intussusception between January 1990 and June 2006 were retrospectively reviewed. Data related to presentation, diagnosis, treatment, and pathology were analyzed.

Results: Seventy-two patients underwent surgery for intestinal intussusception. Neoplasm was identified as the cause of intussusception in 66 (92%) cases, and 6 (8%) were idiopathic. The incidence of malignant colonic intussusception (63%) was significantly higher than that of enteric intussusception (20%), P = 0.001. Primary colon adenocarcinoma (8 of 10 patients, 80%) and malignant lymphoma (2 of 10 patients, 20%) were the two most common underlying malignant lesions in the colon. Lipoma (15 of 40 patients, 38%) and Peutz-Jegher adenoma (10 of 40 patients, 25%) were the two most common lesions of benign small bowel neoplasms while 27% (3 of 11) of malignant enteric intussusception cases were malignant lymphoma and metastatic respectively.

Conclusion: Lipoma is the most common benign tumor in both small and large bowel intussusception. Whereas 80% of tumors associated with small bowel intussusception were benign, two-thirds of colonic intussusceptions had resulted from primary adenocarcinoma.