Forty cases of intussusception in adults at the department of general surgery, Presbyterian medical center between Jan. 1959 to August 1968 are reviewed.
1. This disease occurred most frequently in the fifth decade of life and sex incidence was 2:1 in favor of male.
2. Comparing with the children, clinical course was more chronic in the adults. Duration from the onset of the symptoms to the operation was over 1 week in 75%.
3. Clinical manifestations of the disease were intermittent abdominal pain, abdominal mass, nausea, vomiting and bloody stool.
4. In the majority of the patients, WBC count was within normal range. Six patients had marked leukocytosis(over 15,000/cu.mm.). Among them 4 patients had gangrenous bowel at the time of operation.
5. Intestinal amebiasis was seen more commonly in the patients with intussusception. The other parasitic infestation was not higher in the intussusception cases than normal indivisuals.
6. Barium enema was performed in 18 patients and showed positive findings in 16 patients. Intussusception was reduced by barium enema in one case.
7. Predisposing factors were found in 17 cases(42.5%); malignant lymphoma of ileum in 3 cases, adenocarcinoma of ileum in 1 case, Kaposi´s sarcoma of cecum in 1 case, acute appendcitis in 1 case, mesenteric lymphadenitis in 1 case, postoperative adhesion in 4 cases and amebiasis in 6 cases.
8. Ileocolic intussusception was most common(77.5%) and more chronic course was noted in this type.
9. All cases recieved the operations. The types of operation were reduction of intussusception in 27 cases, resection of bowel in 12 cases. Intussusception was found already reduced by previous barium enema in one case.
10. Postoperative complications were as follows; late recurrence of intussusception in 3 cases, bowel obstruction due to adhesion in 4 cases, wound infection in 2 cases and pneumonitis in 1 case. One patient died of septicemia and colocutaneous fistula on the 15th postoperative day.
11. Co-existing disease at the time of intussusception were chronic cholecystitis in 3 cases, liver abscess in 1 case, liver cirrhosis with clonorchiasis in 1 case, peptic ulcer of the stomach in 1 case and pulmonary tuberculosis in 1 case.
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