Role of clinical and CT findings in the identification of adult small-bowel intussusception requiring surgical intervention
Autor: | R. Müller-Wille, M Georgieva, Wolf Bäumler, Andreas Schicho, S M Brunner, Christian Stroszczynski, K Müller, Marco Dollinger |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Adult
Male medicine.medical_specialty AcademicSubjects/MED00910 610 Medizin Patient characteristics Computed tomography Intussusception (medical disorder) Abdomen Intestine Small Medicine Humans Ct findings ddc:610 medicine.diagnostic_test Adult patients business.industry General Medicine Middle Aged medicine.disease Bowel obstruction Bowel intussusception computed tomography adult intestinal obstruction intestine small intussusception surgical procedures operative neoplasms Etiology Original Article Radiology business AcademicSubjects/MED00010 Tomography X-Ray Computed Intussusception |
Zdroj: | BJS Open |
ISSN: | 2474-9842 |
Popis: | Background In adults, intussusception has been considered traditionally to have an underlying aetiology. The aim of this study was to determine CT and clinical features of small-bowel intussusceptions that required surgical intervention. Methods Adult patients were identified in whom small-bowel intussusceptions were noted on CT images. The appearance, number, type (enteroenteric versus enterocolic), length and maximum short-axis diameter of intussusceptions, and presence of bowel obstruction (short-axis diameter of proximal small bowel greater than 3 cm) were analysed. The outcome was defined as surgical (complicated) or self-limiting (uncomplicated). Associations between complicated and uncomplicated intussusceptions and patient characteristics were investigated. Results Among 75 patients (56 male) with a mean age of 45 years, 103 intussusceptions were identified, of which 98 (95 per cent) were enteroenteric and 5 (5 per cent) enterocolic. Only 12 of 103 intussusceptions (12 per cent) in 12 of 75 (16 per cent) patients required surgical therapy and were considered to be complicated, with half of these having a neoplastic lead point. Length (P < 0.001), diameter (P < 0.001) and type (P = 0.002) of intussusception as well as presence of vessels (P = 0.023) within an intussusception on a CT scan, clinical symptoms (P = 0.007) and signs of bowel obstruction (P < 0.001) were associated with a surgical outcome. Conclusion Clinical symptoms, signs of bowel obstruction, type and length of intussusception, and a visible tumour within an intussusception on CT scan were critical signs of complicated intussusception, requiring surgical intervention. Small bowel intussusceptions in adults are usually considered to have an underlying disease in nearly all cases. The authors evaluated retrospectively the clinical significance of 103 small bowel intussusceptions in 75 adult patients detected by CT by analysing the characteristics of patients, CT morphology of intussusceptions and correlation of surgical results in nearly one-third of patients. Only 12 of 103 intussusceptions (12 per cent) in 12 of 75 (16 per cent) patients required surgical therapy. Clinical symptoms, signs of bowel obstruction, type and length of intussusception, and a visible tumour within an intussusception on a CT scan were critical signs of complicated intussusception, that is one requiring surgical treatment. |
Databáze: | OpenAIRE |
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