Abstract
BACKGROUND Adult intussusception (AI) is a rare condition with diverse clinical presentations and management challenges. Despite its rarity, understanding its epidemiology, clinical features, and predictive factors distinguishing benign and malignant lead points is crucial for effective management. This study aimed to assess the demographic and clinical characteristics of patients with pathological AI and examine factors associated with malignant lead points. MATERIAL AND METHODS Medical records of patients aged >18 years with diagnosis of AI between January 1, 2014, and January 1, 2024 were retrospectively analyzed. Patients were classified based on location and etiology of intussusception. Predictive factors for malignant lead points were assessed, including age, sex, presenting symptoms, location, and size of intussusception. Computed tomography (CT) scan images were reviewed for diagnosis confirmation. Transient small bowel intussusceptions and intussusceptions related to feeding tubes were excluded. RESULTS Twenty-six cases of pathological AI were identified over 10 years, with a male predominance (69.2%) and a mean age of 53.3 years. Abdominal pain was the most common presenting symptom (65.4%), with bowel obstruction diagnosed in 23.1% of cases. CT scans were the primary diagnostic modality (92.3%). Colocolic intussusceptions were most prevalent (53.8%), and surgical management was common (69.2%). Histopathological examination revealed benign lead points in the majority (57.7%) of cases, with lipomas and polyps being the most common. Bleeding per rectum was significantly associated with malignant lead points (P=0.011). CONCLUSIONS AI presents with diverse clinical features. It predominantly affects the colon. Bleeding per rectum indicates a higher likelihood of malignant lead points. A multidisciplinary approach is essential for optimal case-based management.