How do adult and paediatric intussusceptions differ? A 10-year retrospective study

Introduction: Intussusception in adult is considered to be an uncommon surgical condition. Our study aims to gather the epidemiology data of intussusception in local population and to compare the clinical characteristics, investigation and management between adult and paediatric intussusceptions. Methods: This is a retrospective study of patients who were diagnosed intussusception from January 2001 to June 2011 in the study centre. Demographic data, clinical presentation, investigation and management were compared between adult and paediatric patients. Results: There were 79 patients included in the study period. Twenty-two of them (27.8%) were adults (aged at least 18 years) while 57 (72.2%) of them were paediatrics patients (age <18 years). Forty-three (54.4%) of them were male and 36 (45.6%) of them were female. Mean age of intussusception in adult and paediatric groups were 56.1 years and 23.9 months respectively. The median duration of onset of the presentation of adult patient was 3.5 days which is longer than that of paediatrics group (1 day) (p<0.001), per-rectal bleeding occurred in 18.2% (4/22) of adult patients while 47.4% (27/57) of paediatric intussusception had per-rectal bleeding (p=0.017). There was also significantly more vomiting (78.9%, 45/57) in paediatric intussusception compared with 31.8% in adults (p<0.001). A total of 72.7% (16/22) of adult intussusception were diagnosed by CT scan while 94.7% (54/57) of paediatrics was diagnosed by ultrasound by radiology department. 77.3% (17/22) of the adult intussusceptions had a neoplastic leading point. All the adult intussusception required surgical management while only 21.1% (12/57) of the paediatrics group required surgical reduction with or without bowel resection. The median length of stay (LOS) of adult group was 9 days which is longer than that of the paediatrics group (4 days) (p<0.001). Conclusions: Intussusception in adult patients lacks classical presentation of per-rectal bleeding and vomiting and the onset is commonly sub-acute when compared with paediatrics cases. Most of the adult intussusceptions have pathological leading points that warrant surgical management. (Hong Kong j.emerg.med. 2012;19: 272-277)