Adult intussusception: presentation, management, and outcomes of 148 patients.
J Emerg Med
; 43(1): 1-6, 2012 Jul.
Article
em En
| MEDLINE
| ID: mdl-22244289
ABSTRACT
BACKGROUND:
Intussusception is a predominantly pediatric diagnosis that is not well characterized among adults. Undiagnosed cases can result in significant morbidity, making early recognition important for clinicians. STUDYOBJECTIVES:
We describe the presentation, clinical management, disposition, and outcome of adult patients diagnosed with intussusception during a 13-year period.METHODS:
A retrospective study of consecutive adult patients diagnosed with intussusception at a tertiary academic center was carried out from 1996 to 2008. Cases were identified using International Classification of Diseases, 9(th) Revision codes and a document search engine. Data were abstracted in duplicate by two independent authors.RESULTS:
Among 148 patients included in the study, the most common symptoms at presentation were abdominal pain (72%), nausea (49%), and vomiting (36%). Twenty percent were asymptomatic. Sixty percent of cases had an identifiable lead point. Patients presenting to the emergency department (ED) (31%) had higher rates of abdominal pain (relative risk [RR] 5.7) and vomiting (RR 3.4), and were more likely to undergo surgical intervention (RR 1.8) than patients diagnosed elsewhere. There were 77 patients who underwent surgery within 1 month; patients presenting with abdominal pain (RR 2.2), nausea (RR 1.7), vomiting (RR 1.4), and bloody stool (RR 1.9) were more likely to undergo surgery.CONCLUSIONS:
Adult intussusception commonly presents with abdominal pain, nausea, and vomiting; however, approximately 20% of cases are asymptomatic and seem to be diagnosed by incidental radiologic findings. Patients presenting to an ED with intussusception due to a mass as a lead point or in an ileocolonic location are likely to undergo surgical intervention.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doenças do Colo
/
Serviço Hospitalar de Emergência
/
Hemorragia Gastrointestinal
/
Doenças do Íleo
/
Intussuscepção
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article