Non-operative Management of Adult Intussusception

Assessment and Management

• Evaluate patients for signs of peritonitis, strangulation, or bowel ischemia, which would necessitate immediate surgical intervention, as recommended by the World Journal of Emergency Surgery guidelines 1, 2
• Confirm diagnosis with CT scan, which is more sensitive than plain radiographs for detecting complications, according to the World Journal of Emergency Surgery guidelines 2, 3
• Assess hemodynamic stability, as non-operative management should only be attempted in stable patients, as stated by the World Journal of Emergency Surgery guidelines 4
• Consider colonoscopic reduction in selected cases where the intussusception is located in the colon, endoscopic expertise is readily available, and the patient is stable without signs of bowel compromise, as recommended by the World Journal of Emergency Surgery guidelines 1, 4, 5
• Note that endoscopic reduction is associated with higher recurrence rates, as reported by the World Journal of Emergency Surgery guidelines 1
• Close clinical monitoring for at least 24 hours after successful reduction is necessary, as recommended by the World Journal of Emergency Surgery guidelines 4
• Surgical consultation should be obtained in all cases, even when attempting non-operative management, as stated by the World Journal of Emergency Surgery guidelines 4
• If non-operative reduction is unsuccessful or only partially successful, do not delay surgical intervention, as recommended by the World Journal of Emergency Surgery guidelines 1, 2
• Surgical exploration is recommended if signs of peritonitis develop, the patient becomes hemodynamically unstable, or no progression is seen during reduction attempts, as stated by the World Journal of Emergency Surgery guidelines 1, 2