The role of laparoscopy in adult bowel obstruction caused by intussusception

Ann Ital Chir. 2014 Jul-Aug;85(4):328-31.

Abstract

Aim: The intestinal intussusception in the adult represent 1% of all occlusions. Organic causes are detectable in 90% of cases. Aim of this study is to discuss the diagnostic and therapeutic iter of adult intestinal intussusception with particular emphasis on role of laparoscopy.

Materials and methods: We retrospectively considered 10 cases of intussusception between January 2000 and January 2013, demographic and clinical issue, location of invagination, the type of surgical treatment, the post-operative morbidity and mortality and histological nature of occlusion cause.

Results: Ten (F: M 1.5:1) patients were admitted in emergency with bowel obstruction, the median age was 50 years (r.18-91). All required surgical treatment. Three patients (30%) underwent a totally laparoscopic procedure, four patients (40%) laparoscopic exploration followed by laparotomy, three patients (30%) open surgery directly. The invagination was ileo-ileal (50%), ileo-colonic (40%) and colo-colonic (10%). Nine out of ten underwent to surgical resection. The malignancy was the most frequent cause.

Discussion: In case of colonic intussusception should not be performed any reduction because the frequent association with neoplastic disease. The laparoscopy can be safe and effective to allow, in entero-enteric and entero-colic intussusception, the definitive treatment of the occlusion. In the case of colo-colonic intussusception laparoscopy is a valuable diagnostic aid and can facilitate the later processing.

Conclusion: The intestinal invaginations diagnosis can often be difficult. Laparoscopy is safe and effective in the diagnosis and treatment of adult intussusception.

MeSH terms

  • Adolescent
  • Adult
  • Colon
  • Female
  • Humans
  • Ileal Diseases / complications
  • Ileal Diseases / diagnosis*
  • Ileal Diseases / surgery
  • Intestinal Obstruction / diagnosis
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / surgery
  • Intussusception / complications
  • Intussusception / diagnosis*
  • Intussusception / surgery*
  • Laparoscopy*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult