Transient intussusception

Last revised by Henry Knipe on 25 Apr 2024

Transient or uncomplicated intussusception is known to occur in adults and children and can be considered physiological. Given the condition's transient nature, it is probably underdiagnosed. The main factors distinguishing transient from intussusceptions requiring surgical intervention are absent clinical symptoms, enteroenteric type, short length, and absent visible lead point 9.

Intussusceptions are often seen on CT imaging in patients with and without abdominal symptoms 9,10. Asymptomatic patients are, unsurprisingly, more likely to have transient/uncomplicated intussusceptions not requiring surgical intervention 9.

The exact etiology of intussusceptions without a lead point is not clear 4.

Cannabinoids have been associated with single or multiple transient jejunal Intussusceptions 5.

The appearance of transient intussusceptions on ultrasound typically the bowel-within-bowel (+/- meseneteric fat and/or vessels) or a complex soft tissue mass 4,10. A target sign may be present.

CT features that favor transient intussusception over intussusception requiring surgery include:

  • transitory (if multiple phases are acquired) 4

  • jejunal location ref

  • enteroenteric intussusception 9

  • multiple 9 although are frequently solitary 7

  • length <3.5 cm 9,10, although two-thirds of transient intussusceptions are ≥3.6 cm 9

  • absence of visible lead point 9

  • small diameter (due to lack of lead point tumor) 4,9

  • absence of small bowel obstruction 4,9,10

  • absense of mural thickening/edema and mesenteric vascular engorgement 10

  • spontaneous resolution is the rule 4

  • occasionally, laparoscopic reduction is required in patients with a clearly transient/uncomplicated intussusception

  • cessation of any marijuana use ref

Intussusception in adults has a strong association with bowel pathology:

  • transient/uncomplicated enteroenteric intussusception can be secondary to increased bowel peristalsis due to downstream bowel obstruction (e.g. stricture, tumor) 10

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