Intussusception

ABSTRACTIntussusception is quite common in the gastrointestinal tract and that too in the paediatric population though the aetiology is mostly idiopathic (90%). While in adults it is rare and is usually caused by an identifiable underlying lesion mainly neoplasm (70-90%) which usually acts as a lead point. It has a non-specific clinical presentation with a limited role of history and examination in the final diagnosis and Computed tomography is considered the gold standard investigation in establishing the diagnosis. We present an unusual case of jejuno-jejunal intussusception which was caused by a leiomyoma polyp. Thus an Exploratory laparotomy was done, resecting the polyp with the jejunal segment and the diagnosis was confirmed by histopathological examination. Keywords: Intussusception, Jejunal, Leiomyoma, Histopathology

In routine practice every surgeon has to come across this surgical emergency and treatment would largely depend on early diagnosis and skillful management. The objective is to study various causes, symptomatology, various modalities (surgical) of treatment, the role of imaging studies in determining the etiology and intervention and complications of various surgical procedures of intestinal obstruction. A total number of 50 cases of intestinal obstruction have been studied between April 2014 to june 2015, patients who attended OPD and emergency department at Govt Medical college and Associated Group of Hospitals, KOTA Rajasthan with history and clinical picture suggestive of intestinal obstruction, also the patients who had hernia with recent onset of irreducibility, pain, vomiting and constipation were also included in this study. Paediatric  patients and patients who were having sub acute or adynamic intestinal obstruction treated conservatively were excluded from the study. The study was of 50 patients  done in all age groups ranging from 11 to 80yrs with a mean age of 44.8 years. Maximum incidence was seen between age group of 51-60 yrs (22%) followed by the age group 41-50 (20%). Males are more commonly involved (4.5:1) than females and small bowel is more commonly involved (70%). And adhesion followed by obstructed hernia are common cause of intestinal obstruction. Apart from postoperative adhesion other causes of intestinal obstruction like obstructed inguinal hernia, tubercular stricture, large bowel volvulus and large bowel neoplasms should be dealt promptly to prevent strangulation. Early diagnosis and emergent management are the key of better outcome.