Intussusception in Adults; Direct and Retrograde Types

บทคัดย่อ

Nine patients over 15 years of age admitted to the Chaoprayayomraj Hospital, Suphan Buri, in 6 years period from October 1985 to September 1991,in whom the diagnosis of intussusception was documented at laparotomy, were discovered and their records were retrospectively studied. The incidences of them were approximately 0.001 % of all types of patients, 0.01 % of general surgical patients. 6.6 % of all cases with gut obstruction who received surgical treatments, and 45 % of all intussusception in that 6 years period. Their age ranged from 29 to 82 years with a mean age of 55 years. There were 6 women and 3 men. More cases had chronic symptoms,and their symptoms and signs were not typical. Barium enema were done in 8 cases,demonstrated intussusception in 7 cases, and one case of retrograde colic intussusception.

The other 8 cases had direct intussusception of which anatomic types were ileoileal (3 patients), ileocolic (1 patient), cecocolic (1 patient), and colic (3 patients). Resections of the involved intestinal segments with end to end anastomoses were made in all cases. All cases had leading causes which were benign tumors in 5 patients and malignant tumors in 3 patients. Summary of clinical, radiological and pathological findings of all cases are reported, and the literatures of intussusception in adults with emphasis on retrograde type are reviewed.