A 45-year-old man presents with intermittent colicky abdominal pain and vomiting for 2 weeks. Ultrasound shows a 'target sign' or 'doughnut sign' in the right abdomen. CT confirms ileocolic intussusception with a hypodense lead point. What is the most appropriate management?
- A Surgical resection without attempted reduction ✓
- B Barium enema reduction under fluoroscopy
- C Hydrostatic reduction with air enema
- D CT-guided percutaneous reduction
Correct answer: A. Surgical resection without attempted reduction
Explanation
In adults, intussusception is caused by a pathologic lead point in over 90% of cases (tumor, Meckel's diverticulum, polyp). Unlike pediatric intussusception where pneumatic or hydrostatic reduction is standard, adult intussusception requires surgical resection without attempted reduction because the lead point is often malignant and reduction risks tumor dissemination or venous embolization.
Reference: Sabiston Textbook of Surgery, 21st ed.
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Written and medically reviewed by the StethoPrep medical team.