A 62-year-old man presents with intermittent central colicky pain, vomiting, and a palpable mobile right-sided abdominal mass. CT shows the classic 'target' or 'doughnut' sign of ileocolic telescoping. In adults, what is the usual implication of this finding regarding management?

• A Air enema reduction is definitive and surgery can be avoided
• B Observation with repeat imaging is sufficient as it resolves spontaneously
• C Manual operative reduction followed by appendicectomy is adequate
• D A pathological lead point is likely, so en bloc resection without reduction is preferred ✓

Explanation

Unlike childhood intussusception, which is usually idiopathic and reduced non-operatively, adult intussusception almost always has a structural lead point, commonly a benign polyp or a malignant neoplasm. Because manipulation risks seeding malignant cells and the lead point must be removed, standard practice is segmental en bloc resection with primary anastomosis without prior reduction. Air enema reduction is reserved for children.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.