Benign Versus Malignant Causes of Intussuception in Adults

Benign Versus Malignant Causes of Intussuception in Adults : A Prospective Study in Assiut University Hospital

The aim of this study is to evaluate adult intussecption :

• Prevalence of benign vs malignant causes.
• Distribution by anatomical type.
• Clinical presentation patterns.
• Diagnostic accuracy of imaging.
• Surgical approach and outcomes.
• Length of hospital stay, complications, recurrence

Study Overview

• Status: Not yet recruiting
• Conditions: Intussusception (IS)
• Intervention / Treatment: Procedure: surgical resection and histopathological examination

Detailed Description

Intussusception is a condition characterized by the invagination of one segment of the intestine into another, leading to obstruction and potentially ischemia (1). While intussusception is relatively common in the pediatric population, it is considered a rare clinical entity in adults, accounting for only 1-5% of all cases and approximately 1% of intestinal obstructions in the adult population. The etiology, clinical presentation, and management of adult intussusception differ significantly from pediatric cases, necessitating a distinct clinical approach (2).

In contrast to children, where most cases are idiopathic, adult intussusception is commonly associated with an underlying pathological lead point. In approximately 70-90% of adult cases, a structural lesion can be identified as the cause of the intussusception (3). These lesions may be benign or malignant in nature and understanding the incidence of each is important for appropriate diagnosis and treatment planning (4).

In general, intussusceptions involving the small intestine are more likely to be caused by benign lesions such as lipomas, polyps, or Meckel's diverticulum, whereas those involving the colon have a higher likelihood of being associated with malignancy, especially primary adenocarcinoma (5).

Adult intussusception poses a diagnostic challenge due to its nonspecific and often chronic symptoms, which may include intermittent abdominal pain, nausea, vomiting, gastrointestinal bleeding, or signs of partial bowel obstruction (6).

The advent of advanced imaging techniques, particularly abdominal computed tomography (CT), has improved the preoperative diagnosis of this condition (7). However, surgical exploration remains the definitive diagnostic and therapeutic modality, especially given the high probability of underlying malignancy (8).

Despite advancements in diagnostic imaging and surgical techniques, there remains a lack of general agreement regarding the optimal management of adult intussusception, particularly concerning the necessity and extent of bowel resection when a benign cause is suspected (9). Moreover, data on the relative incidence of benign versus malignant causes vary widely across regions, institutions, and populations.

This study aims to evaluate adult intussecption, prevalence of benign versus malignant causes in AUH.

• Study Type: Interventional
• Enrollment (Estimated): 35
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Andrew gamal fikry, MBBCH, MSc ( general surgury ); Phone Number: +201224173419; Email: gamalandrew751@gmail.com

Study Locations

• Egypt
  • Asyut, Egypt
    • Department of general surgury Assiut uneversity hospital
    • Contact: Andrew gamal fikry, MBBCh, MSc (general surgury); Phone Number: +201224173419; Email: gamalandrew751@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

a. Inclusion criteria:

• Age ≥ 19 years.

  • Confirmed diagnosis of intussusception by: Imaging (CT , ultrasound , or barium studies) Intraoperative findings,

  • Patients managed surgically with documented follow-up and final diagnosis. b. Exclusion criteria:
  • Patients with incomplete records or lost to follow-up
• Intussusception diagnosed radiologically but resolved spontaneously without confirmatory intervention or follow-up

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Other: Adult patient with intussusception; Adult patient with intussusception will undergo surgical resection followed byhistopathological evaluation to determine the underlying causes ( benign or malignant )

Procedure: surgical resection and histopathological examination; Adult patient diagnosed with intussusception will undergo surgical resection of affected bowel segment under general anathesia . the resected specimens will be sent for histopathological evalution to determine the underlying cause , whether benign (e.g lipoma , polyp )or malignant (e.g adenocarcinama , lymphoma ). operative finding , postoperative outcome , and pathology results will be recorded and analyzed

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
prevalence of benign versus malignant causes	Histopathological examination of resected bowel specimens will determine whether the cause of intussusception is benign (e.g., lipoma, polyp) or malignant (e.g., adenocarcinoma, lymphoma). The frequency and percentage of each category will be calculated	2 weeks after surgical resection

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Correlation between preoperative imaging findings and histopathological results Description	Evaluate the diagnostic accuracy of preoperative imaging (CT scan findings such as target sign, mass lesion) in predicting benign or malignant pathology	At the time of diagnosis (preoperative period )

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Operative findings	To record intraoperative findings including location of intussusception (small bowel, ileocecal, colocolic), presence of lead point, bowel viability, and type of surgical procedure	During intraoperative period

Collaborators and Investigators

• Sponsor: Assiut University

Publications and helpful links

General Publications

• Su T, He L, Zhou T, Wu M, Guo Y, Wang Q, Jiang J, Cao X. Most Adult Intussusceptions are Caused by Tumors: A Single-Centre Analysis. Cancer Manag Res. 2020 Oct 12;12:10011-10015. doi: 10.2147/CMAR.S268921. eCollection 2020.

Study record dates

Study Major Dates

• Study Start (Estimated): December 1, 2025
• Primary Completion (Estimated): December 1, 2027
• Study Completion (Estimated): December 1, 2027

Study Registration Dates

• First Submitted: November 16, 2025
• First Submitted That Met QC Criteria: November 16, 2025
• First Posted (Actual): November 20, 2025

Study Record Updates

• Last Update Posted (Actual): November 20, 2025
• Last Update Submitted That Met QC Criteria: November 16, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: in adult
• Additional Relevant MeSH Terms: Intestinal Diseases; Digestive System Diseases; Gastrointestinal Diseases; Intestinal Obstruction; Intussusception
• Other Study ID Numbers: Intussusception in adult

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No