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In the era of routine use of CT scan for acute abdominal pain, should all adults with small bowel intussusception undergo surgery?
Olasky, Jaisa; Moazzez, Ashkan; Barrera, Kaylene; Clarke, Tatyan; Shriki, Jabi; Sohn, Helen J; Katkhouda, Namir; Mason, Rodney J.
Afiliação
  • Olasky J; LAC-USC Medical Center, Los Angeles, California, USA.
Am Surg ; 75(10): 958-61, 2009 Oct.
Article em En | MEDLINE | ID: mdl-19886144
ABSTRACT
In contrast to adult colonic intussusception in which malignancy is the dominant cause, small bowel intussusceptions are mostly benign. Although surgery is the accepted standard treatment, its necessity in small bowel intussusceptions identified by CT scan is unknown. Twenty-three patients from 2005 to 2008 (16 males; median age, 44 years) with acute abdominal pain and CT-proven small bowel intussusception were studied. Factors associated with the necessity for surgery were determined. Among 11 patients who were managed operatively, surgery was deemed unnecessary in two patients based on negative explorations. Follow up in 10 of 12 patients managed nonoperatively was not associated with any recurrence of intussusception or malignancy (median follow up, 14 months). The only predictor of the need for surgery was CT evidence of small bowel obstruction and/or a radiologically identified lead point, which was present in 7 of 9 (78%) patients having a necessary operation and absent in 12 of 14 (86%) with no indication for surgery (P = 0.008). All small bowel intussusceptions found on CT scan in patients with acute abdominal pain do not require operative management. CT findings of small bowel obstruction and/or presence of a lead point are indications for surgery.
Assuntos
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Base de dados: MEDLINE Assunto principal: Tomografia Computadorizada por Raios X / Dor Abdominal / Intestino Delgado / Intussuscepção Idioma: En Ano de publicação: 2009 Tipo de documento: Article País de afiliação: Estados Unidos
Buscar no Google
Base de dados: MEDLINE Assunto principal: Tomografia Computadorizada por Raios X / Dor Abdominal / Intestino Delgado / Intussuscepção Idioma: En Ano de publicação: 2009 Tipo de documento: Article País de afiliação: Estados Unidos