Title:Clinical Presentations, MDCT Features, and Treatment of Three Types of Adult
Intussusceptions Based on the Location
Volume: 20
Author(s): Qiu-jie Dong, Jing Shi, Chun-lai Zhang, Xiao-guang Li, Xiao Chen and Yi Wang*
Affiliation:
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing 400042, China
Keywords:
Adult, Intussusception, Therapeutics, Multidetector computed tomography, Risk factors, Ischemia.
Abstract:
Purpose:
This study aimed to explore the similarities and differences in clinical presentations, multidetector computed tomographic (MDCT) features, and
treatment of three types of adult intussusceptions based on location.
Methods:
We retrospectively reviewed 184 adult patients with 192 intussusceptions. Depending on the location, intussusceptions were classified as enteric,
ileocolic, and colonic types. The similarities and differences of clinical presentations, MDCT features, and treatment of three types of adult
intussusception were compared. Meanwhile, the three types of intussusceptions were further divided into surgical and conservative groups based
on the treatment. Uni- and multivariate logistic analyses were used to identify risk factors for intussusception requiring surgery.
Results:
Enteric and ileocolic intussusceptions were mainly presented with abdominal pain (78.46% and 85.71%). Hematochezia/melena (64.29%) was the
main symptom of colonic intussusception. On MDCT, ileocolic intussusceptions were longer in length and had more signs of intestinal necrosis
(hypodense layer, fluid collection and no/poor bowel wall enhancement) than enteric and colonic intussusceptions. Moreover, it was found that
93.88% (46/49) of ileocolic intussusception and 98.59% (70/71) of colonic intussusception belonged to the surgical group, whereas only 43.06%
(31/72) of enteric intussusception belonged to the surgical group. Intussusception length (OR=1.171, P=0.028) and discernible lead point on
MDCT (OR=21.003, P<0.001) were reliable indicators of enteric intussusception requiring surgery.
Conclusion:
Ileocolic intussusception may be more prone to intestinal necrosis than enteric and colonic intussusceptions, requiring more attention from
clinicians. Surgery remains the treatment of choice for most ileocolic and colonic intussusceptions. Less than half of enteric intussusceptions
require surgery, and MDCT features are effective in identifying them.
