Ulus Travma Acil Cerrahi Derg. 2009; 15(2): 154-158

Eriþkinlerde invajinasyon

Özgür korkmaz, Hatice Gülþen Yýlmaz, Ýbrahim Halil Taçyýldýz, Yýlmaz Akgün
Dicle Üniversitesi Týp Fakültesi Genel Cerrahi Anabilim Dalý, Diyarbakýr

AMAÇ: Eriþkinlerde invajinasyon nadir görülen bir klinik durumdur, çocuk olgulardan etyolojik farklýlýklar gösterir. Çalýþmamýzda, eriþkinlerde saptanan invajinasyon nedenlerinin tanýmlanmasý ve tedavi özeliklerinin deðerlendirilmesi amaçlandý.
GEREÇ-YÖNTEM: 1986 ile 2006 yýllarý arasýnda invajinasyon tanýsý alan olgular geriye dönük olarak deðerlendirildi. Tüm olgular 18 yaþýn üzerinde olup; rektal, gastroenterostomiye baðlý ve stomal prolapsusu olan olgular çalýþma dýþý tutuldu.
BULGULAR: Toplam 28 invajinasyon olgusu belirlendi; ortalama yaþ 38,6±16,7 idi. Ameliyat öncesi taný olgularýn %53,5’ünde gerçekleþtirildi. Olgularýn 23’ünde ince baðýrsak, üçünde kolon, ikisinde ise ileokolik invajinasyon saptandý. Ýnvajinasyon nedeni 25 (%89,3) olguda belirlendi. Ýnvajinasyon nedenleri 19 olguda selim, altý olguda habis ve üç olguda ise idyopatikti. Ameliyat sonrasý üç (%10,3) olguda komplikasyon görüldü.
SONUÇ: Bu serideki yaþ ortalamasý literatür verilerinden daha düþük bulundu. Sýklýkla ince baðýrsak invajinasyonlarýna rastlanýrken, selim/habis oranýnda, selim aðýrlýkta idi. Eriþkinde görülen invajinasyon nadir görülmesine karþýn, geniþ bir etyolojik açýlýmý ve deðiþken klinik tablosu nedeniyle, özellikle akut karýn tablosuyla karþýlaþan her hekim için ayýrýcý tanýda göz önünde bulundurulmasý gereken bir durumdur.

Anahtar Kelimeler: Eriþkin, invajinasyon/etyoloji/taný yöntemleri; karýn aðrýsý/etyoloji.

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Intussusception in adults

Özgür korkmaz, Hatice Gülþen Yýlmaz, Ýbrahim Halil Taçyýldýz, Yýlmaz Akgün
Department Of General Surgery, Dicle University Faculty Of Medicine, Diyarbakýr, Turkey

BACKGROUND: Adult intussusception is an unusual entity, and its etiology differs from that in pediatric patients. The purpose of this study was to determine the causes and management of intussusception in adults. METHODS: A retrospective review of patients with a diagnosis of gastrointestinal intussusception between 1986 and 2006 was conducted. All patients under the age of 18 and cases with rectal, ostomy, or gastroenterostomy prolapse were excluded. RESULTS: There were 28 cases of adult intussusception. Mean age was 38.6±16.7 years. A preoperative diagnosis of intussusception was made in 53.5% of the cases. There were 23 enteric, three colonic and two ileocolic intussusceptions. A lead point was identified in 25 patients (89.3%). Invagination was due to benign causes in 19 patients, malignant causes in six patients and idiopathic in three patients. Complication was seen in three (10.3%) cases.
CONCLUSION: In this series, the mean age of the patients was younger than in the literature. Since intussusception was due to small bowel pathologies, the proportion of benign/malignant lesions favored benign lesions. Although it is encountered rarely in adults, physicians should be aware of invagination and consider it in each case of acute abdomen because of the wide spectrum of the clinical settings.

Keywords: Adults, intussusception/etiology/diagnosis; abdominal pain/etiology.

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