Benign Versus Malignant Causes of Intussuception in Adults

Intussusception is a condition characterized by the invagination of one segment of the intestine into another, leading to obstruction and potentially ischemia (1). While intussusception is relatively common in the pediatric population, it is considered a rare clinical entity in adults, accounting for only 1-5% of all cases and approximately 1% of intestinal obstructions in the adult population. The etiology, clinical presentation, and management of adult intussusception differ significantly from pediatric cases, necessitating a distinct clinical approach (2).

In contrast to children, where most cases are idiopathic, adult intussusception is commonly associated with an underlying pathological lead point. In approximately 70-90% of adult cases, a structural lesion can be identified as the cause of the intussusception (3). These lesions may be benign or malignant in nature and understanding the incidence of each is important for appropriate diagnosis and treatment planning (4).

In general, intussusceptions involving the small intestine are more likely to be caused by benign lesions such as lipomas, polyps, or Meckel's diverticulum, whereas those involving the colon have a higher likelihood of being associated with malignancy, especially primary adenocarcinoma (5).

Adult intussusception poses a diagnostic challenge due to its nonspecific and often chronic symptoms, which may include intermittent abdominal pain, nausea, vomiting, gastrointestinal bleeding, or signs of partial bowel obstruction (6).

The advent of advanced imaging techniques, particularly abdominal computed tomography (CT), has improved the preoperative diagnosis of this condition (7). However, surgical exploration remains the definitive diagnostic and therapeutic modality, especially given the high probability of underlying malignancy (8).

Despite advancements in diagnostic imaging and surgical techniques, there remains a lack of general agreement regarding the optimal management of adult intussusception, particularly concerning the necessity and extent of bowel resection when a benign cause is suspected (9). Moreover, data on the relative incidence of benign versus malignant causes vary widely across regions, institutions, and populations.

This study aims to evaluate adult intussecption, prevalence of benign versus malignant causes in AUH.

a. Inclusion criteria:

• Age ≥ 19 years.

• Confirmed diagnosis of intussusception by: Imaging (CT , ultrasound , or barium studies) Intraoperative findings,
• Patients managed surgically with documented follow-up and final diagnosis. b. Exclusion criteria:
• Patients with incomplete records or lost to follow-up
• Intussusception diagnosed radiologically but resolved spontaneously without confirmatory intervention or follow-up