今日の臨床サポート 今日の臨床サポート
関連論文:
img  1:  Adult intussusception: presentation, management, and outcomes of 148 patients.
 
著者: Rachel A Lindor, M Fernanda Bellolio, Annie T Sadosty, Frank Earnest, Daniel Cabrera
雑誌名: J Emerg Med. 2012 Jul;43(1):1-6. doi: 10.1016/j.jemermed.2011.05.098. Epub 2012 Jan 12.
Abstract/Text BACKGROUND: Intussusception is a predominantly pediatric diagnosis that is not well characterized among adults. Undiagnosed cases can result in significant morbidity, making early recognition important for clinicians.
STUDY OBJECTIVES: We describe the presentation, clinical management, disposition, and outcome of adult patients diagnosed with intussusception during a 13-year period.
METHODS: A retrospective study of consecutive adult patients diagnosed with intussusception at a tertiary academic center was carried out from 1996 to 2008. Cases were identified using International Classification of Diseases, 9(th) Revision codes and a document search engine. Data were abstracted in duplicate by two independent authors.
RESULTS: Among 148 patients included in the study, the most common symptoms at presentation were abdominal pain (72%), nausea (49%), and vomiting (36%). Twenty percent were asymptomatic. Sixty percent of cases had an identifiable lead point. Patients presenting to the emergency department (ED) (31%) had higher rates of abdominal pain (relative risk [RR] 5.7) and vomiting (RR 3.4), and were more likely to undergo surgical intervention (RR 1.8) than patients diagnosed elsewhere. There were 77 patients who underwent surgery within 1 month; patients presenting with abdominal pain (RR 2.2), nausea (RR 1.7), vomiting (RR 1.4), and bloody stool (RR 1.9) were more likely to undergo surgery.
CONCLUSIONS: Adult intussusception commonly presents with abdominal pain, nausea, and vomiting; however, approximately 20% of cases are asymptomatic and seem to be diagnosed by incidental radiologic findings. Patients presenting to an ED with intussusception due to a mass as a lead point or in an ileocolonic location are likely to undergo surgical intervention.

Copyright © 2012 Elsevier Inc. All rights reserved.
PMID 22244289  J Emerg Med. 2012 Jul;43(1):1-6. doi: 10.1016/j.jemermed.2011.05.098. Epub 2012 Jan 12.
戻る

さらなるご利用にはご登録が必要です。

こちらよりご契約または優待日間無料トライアルお申込みをお願いします。

(※トライアルご登録は1名様につき、一度となります)


ご契約の場合はご招待された方だけのご優待特典があります。

以下の優待コードを入力いただくと、

契約期間が通常12ヵ月のところ、14ヵ月ご利用いただけます。

優待コード: (利用期限:まで)

ご契約はこちらから