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Intussusception in adolescents and adults: a report on cases from Addis Ababa, Ethiopia, during a three-year period.

BACKGROUND
Though there are few studies, mainly on children, very little is known about its occurrence in Ethiopian adults.


OBJECTIVE
To assess the clinical presentations, clinical findings, operative findings (including types and identification of specific causes), modes of treatment, and postoperative outcome in adult patients operated for intussusception.


METHODS
A retrospective review of adolescent and adult patients' record with intra operative diagnosis of intussusception over a period of three years in three teaching Hospitals in Addis Ababa, Ethiopia, i.e. Tikur Anbassa (TAH), Princess Zewditu Memorial (ZMH) and St. Paul's Hospitals (SPH).


RESULTS
A total of 25 patients were analyzed. Two peak ages of occurrence were identified i.e. the 2nd decade, which represented mainly idiopathic intussusception, and the 4th decade, which was mainly of secondary type. The median duration of illness was 144 hours with a range of 6-720 hours. The Ileo-colic type was identified in 14 (56%) of the cases. Fifteen (60%) cases were primary (Idiopathic). Benign conditions represented the majority (67%) of the identified lead points. Intra operative reduction was successful in only 6 (24%) of the cases, all of which were idiopathic. Four of our patients died giving an overall mortality rate of 16%. All of the deaths were from the idiopathic variety. Irreversible septic shock with multi organ failure was the cause of death.


CONCLUSION
Intussusception is not a rare disease in Ethiopian adults, the primary idiopathic variant occurring with a higher frequency. Identified lead points are usually benign, especially if they are situated in the small intestine. En-block resection of the involved intestinal segment should be the rule if there is an obvious ischemic change and limited resection is recommended if a lead point is identified.