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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.
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