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Adult Intussusception

Etiology. Children

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Adult Intussusception

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    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

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