Clinical problem-solving. The leading diagnosis--a 23-year-old black woman presented to the emergency department with diffuse, colicky abdominal pain of 1 hour's duration

Intussusception in traditional pediatric, nontraditional pediatric, and adult patients

STUDY OBJECTIVES

We sought to determine the rate of intussusception in 3 age groups (traditional pediatric-age [T], nontraditional pediatric-age [N], and adult-age [A]) and to compare group characteristics.

METHODS

We conducted a retrospective records review for patients discharged with diagnosis of intussusception between October 1999 and June 2008.

RESULTS

Ninety-five cases of intussusception were diagnosed as follows: 61 T (64%), 12 N (13%), and 22 A (23%). Bloody stool was more common in T patients (P = .016). Air contrast enema (36%) and ultrasound (33%) were the most common diagnostic tests in T, whereas computed tomography was most common in N (83%) and A (68%) patients. Bowel resection occurred more often in older (T) patients (P = .001). The most frequent causative pathologic conditions were adenitis (T), Peutz-Jeghers polyp (N), and carcinoma (A) and prior gastric bypass in 10 A patients.

CONCLUSIONS

The incidence of intussusception is substantially higher in nontraditional age groups than previously reported. Symptoms, management strategies, and causative pathologic conditions varied with age. All adults with intussusception require definitive diagnostic testing to determine the cause, given the concerning list of possibilities we observed.