Khasawneh Ruba A, Khader Yousef Saleh, Gharaibeh Maha Mohamed, Haj Hussein Ahmed A, Alkhaldi Taqwa, Igbariye Yanal, Khamaiseh Dalia, Abd Elkhalik Doaa Mahmoud
Department of Diagnostic Radiology and Nuclear Medicine, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, Jordan.
Department of Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Med Sci Monit Basic Res. 2024 Dec 5;30:e945845. doi: 10.12659/MSMBR.945845.
BACKGROUND Adult intussusception (AI) is a rare condition with diverse clinical presentations and management challenges. Despite its rarity, understanding its epidemiology, clinical features, and predictive factors distinguishing benign and malignant lead points is crucial for effective management. This study aimed to assess the demographic and clinical characteristics of patients with pathological AI and examine factors associated with malignant lead points. MATERIAL AND METHODS Medical records of patients aged >18 years with diagnosis of AI between January 1, 2014, and January 1, 2024 were retrospectively analyzed. Patients were classified based on location and etiology of intussusception. Predictive factors for malignant lead points were assessed, including age, sex, presenting symptoms, location, and size of intussusception. Computed tomography (CT) scan images were reviewed for diagnosis confirmation. Transient small bowel intussusceptions and intussusceptions related to feeding tubes were excluded. RESULTS Twenty-six cases of pathological AI were identified over 10 years, with a male predominance (69.2%) and a mean age of 53.3 years. Abdominal pain was the most common presenting symptom (65.4%), with bowel obstruction diagnosed in 23.1% of cases. CT scans were the primary diagnostic modality (92.3%). Colocolic intussusceptions were most prevalent (53.8%), and surgical management was common (69.2%). Histopathological examination revealed benign lead points in the majority (57.7%) of cases, with lipomas and polyps being the most common. Bleeding per rectum was significantly associated with malignant lead points (P=0.011). CONCLUSIONS AI presents with diverse clinical features. It predominantly affects the colon. Bleeding per rectum indicates a higher likelihood of malignant lead points. A multidisciplinary approach is essential for optimal case-based management.
背景 成人肠套叠（AI）是一种罕见疾病，临床表现多样，管理面临挑战。尽管其罕见，但了解其流行病学、临床特征以及区分良性和恶性引导点的预测因素对于有效管理至关重要。本研究旨在评估病理性AI患者的人口统计学和临床特征，并检查与恶性引导点相关的因素。
材料与方法 回顾性分析2014年1月1日至2024年1月1日期间年龄>18岁且诊断为AI的患者的病历。根据肠套叠的位置和病因对患者进行分类。评估恶性引导点的预测因素，包括年龄、性别、临床表现、位置和肠套叠大小。复查计算机断层扫描（CT）图像以确认诊断。排除短暂性小肠肠套叠和与饲管相关的肠套叠。
结果 10年间共确诊26例病理性AI，男性占优势（69.2%），平均年龄53.3岁。腹痛是最常见的临床表现（65.4%），23.1%的病例诊断为肠梗阻。CT扫描是主要的诊断方式（92.3%）。结肠结肠型肠套叠最为常见（53.8%），手术治疗很常见（69.2%）。组织病理学检查显示大多数病例（57.7%）的引导点为良性，脂肪瘤和息肉最为常见。直肠出血与恶性引导点显著相关（P = 0.011）。
结论 AI临床表现多样。它主要影响结肠。直肠出血提示恶性引导点的可能性更高。多学科方法对于基于病例的最佳管理至关重要。
