Author
R J Steckler
Bio: R J Steckler is an academic researcher. The author has contributed to research in topics: Bowel resection & Intussusception (medical disorder). The author has an hindex of 1, co-authored 1 publications receiving 252 citations.
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Journal Article•
TL;DR: In a review of literature, it was found that the clinical features in these three cases closely paralleled those of other cases of adult intussusception reported in this country.
Abstract: Three cases of intussusception in adults were observed within a period of six months in a small general hospital. All the patients were over 65 years old and all were admitted to hospital with intermittent cramping abdominal pains. None appeared to be in acute distress. In all three, body temperature, pulse rate and hemogram were within normal limits. Diagnosis was made preoperatively after barium enema studies. Bowel resection with end-to-end anastomosis was done in all three cases, in two because of gangrenous bowel. The site of intussusception was jejunojejunal in one case, ileocecal in another and colorectal in the third; and the cause in all cases was tumor, benign in two cases, malignant in one. The patients recovered uneventfully except for incisional abscess and diarrhea of seven days' duration in one. In a review of literature it was found that the clinical features in these three cases closely paralleled those of other cases of adult intussusception reported in this country.
272 citations
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TL;DR: The CT scan is most useful in making the diagnosis of intussusception and small bowel lesions should be reduced only in patients in whom a benign diagnosis has been strongly suggested preoperatively or in Patients in whom resection may result in short gut syndrome.
Abstract: BackgroundIntussusception in adults is often diagnosed on computed tomography (CT), and the optimal treatment of this entity is not universally agreed upon. We report our experience in an attempt to clarify the usefulness of CT scan and the optimal treatment of this entity.StudySeven cases o
280 citations
TL;DR: It is supported that small-bowel intussusception should be reduced before resection if the underlying etiology is suspected to be benign or if the resection required without reduction is deemed to be massive.
Abstract: Whereas intussusception is relatively common in children, it is clinically rare in adults. The condition is usually secondary to a definable lesion. This study was designed to review adult intussusception, including presentation, diagnosis, and optimal treatment. A retrospective review of 22 cases of intussusception occurring in individuals older than aged 18 years encountered at two university-affiliated hospitals in Winnipeg between 1989 and 2000. The 22 cases were divided to benign and malignant enteric, ileocolic, colonic lesions respectively. The diagnosis and treatment of each case were reviewed. There were 22 cases of adult intussusception. Mean age was 57.1 years. Abdominal pain, nausea, and vomiting were the commonest symptoms. There were 14 enteric, 2 ileocolic, and 6 colonic intussusceptions. Eighty-six percent of adult intussusception was associated with a definable lesion. Twenty-nine percent of enteric lesions were malignant. All ileocolic lesions were malignant. Of colonic lesions, 33 percent were malignant and 67 percent were benign. All cases required surgical interventions except one. Adult intussusception is a rare entity and requires a high index of suspicion. Our review supports that small-bowel intussusception should be reduced before resection if the underlying etiology is suspected to be benign or if the resection required without reduction is deemed to be massive. Large bowel should generally be resected without reduction because pathology is mostly malignant.
270 citations
TL;DR: The diagnosis and management of four cases of adult intussusception are presented, followed by review of the literature.
Abstract: Adult intussusception occurs infrequently and differs from childhood intussusception in its presentation, aetiology, and treatment. Diagnosis can be delayed because of its longstanding, intermittent, and non-specific symptoms and most cases are diagnosed at emergency laparotomy. With more frequent use of computed tomography in the evaluation of patients with abdominal pain, the condition can be diagnosed more reliably. Treatment entails simple bowel resection in most cases. Reduction of the intussusception before resection is controversial, but there is a shift against this, especially in colonic cases. Surgical treatment can be difficult in gastroduodenal and coloanal intussusceptions, sometimes requiring innovative techniques. This paper presents the diagnosis and management of four cases of adult intussusception, followed by review of the literature.
199 citations
TL;DR: Preoperative diagnoses were possible in almost all patients of intussusception and reduction greatly benefited any surgery required and the extent of the resection regardless of the underlying disease and surgical site.
Abstract: Background
Intussusception is common in children but rare in adults. The goal of this study was to review retrospectively the symptoms, diagnosis, and treatment of intussusception in adults.
149 citations
TL;DR: Adult intussusception is an unusual and challenging condition and is a preoperative diagnostic problem and the 20 years of experience in treatment strategies for dealing with such unusual problems are discussed.
Abstract: Purpose
Intestinal intussusception in adults is rare and the optimal management of this problem remains controversial. The purpose of this study was to determine the causes of intussusceptions in adults and to assess their treatment.
143 citations