INTUSSUSCEPTION IN ADULTS - CT DIAGNOSIS

Purpose: Intussusception in adults is nowadays usually diagnosed on co mputed tomography (CT), as CT is often the first modality for the inve stigation of prolonged abdominal pain from which these patients suffer . We wish to present the CT, clinical and pathological findings of 16 adult patients with intussusception seen over a 5-year period. Materia ls and Methods: The abdominal scans of 16 patients with intussusceptio n were reviewed. Special attention was directed to the location of the mass, its shape and fat content, possible underlying pathology and di latation of the bowel proximally. The findings were correlated with cl inical and pathological data. Results: Eight men and eight women, aged 34-81 years, were studied. The most frequent indication for CT was pr olonged abdominal pain, CT findings included an inhomogeneous soft tis sue mass, target or sausage-shaped, depending on the angle of the CT b eam vs, the intussusception, with a fatty component in 14 of the 16, I ntussusception was enteroenteric (six), ileocolic (three), or colocoli c (seven), Complete small bowel obstruction was present only in one ca se and some bowel dilatation in three. The underlying pathology could be diagnosed on CT in only two cases of lipoma, Nine patients had an u nderlying malignant process, eight of them unsuspected. Of the other f ive, two had coeliac disease, two were classified as idiopathic and on e had a necrotic polyp of undetermined pathology. Conclusion: Intussus ception on CT presented a characteristic mass lesion containing fat st ripes in almost ail patients. Obstruction was rarely seen,;Malignant l esions were the most common cause and therefore early diagnosis and pr ompt intervention are essential.