INVAGINATION IN ADULTS AS A RARE CAUSE OF ILEUS

Abstract

While invagination is one of the leading cause of acute abdominal pathology in children, it is a rare clinical entity in adults. Our aim was to evaluate the incidence of invagination as a cause of ileus and re-evaluate the clininical features of patients. The records of 1200 patients who had been operated with the diagnosis of intestinal obstruction in Emergency Surgical Department of Ankara Numune Teaching and Research Hospital during last 10 years were reviewed. 16 (2F) patients with median (range) age of 54 (34-69) years were found to be operated for invagination (1.3%). invagination was ileo-ileal in 13 patients, colo-colic in 1patient; jejuno-duodenal in one patient and jejuno-colic in other one. The patients presented with complaints ranging for hours to months and from nonspesific complaints to signs and symptoms of acute intestinal obstruction. Bowel resection was procedure of choice in 14 patients, 2 patients underwent reduction only, and one of whom also had gastric polip removed. Intraluminal polipoid lesions were identified in 3 patients and one of them was found to be malignant. Invagination was due to adhesions in two patients. No additional pathology was found in remaining 10 patients. Although invagination in adults is very rare, it is commonly due to underlying pathology and diagnosis usually made during operation. Surgery is the treatment of choice in patients with the correct diagnosis. As the suspicion of malignancy will remain as an unanswered question in patients without resection, resection should be done without any attempt to reduce it.