In regard to an article published in the February issue of the Canadian Journal of Surgery,1 entitled "Surgical images: soft tissue. Transverse colonic intussusception," the authors should not have tried manual reduction, since a great percentage of the intussusceptions in adults (up to 65%)2,3 has a malignant origin,4 and manual reduction could cause a dispersion of the tumour. It is necessary to be sure that the lesion has no malignant origin, by sending a transoperatory histopathological test.
Invaginations in adults must be resected without attempting reduction. They are mostly of the ileocolic variety, and coloenteric anastomosis in either case has good results, any time a patient is under adequate intestinal preparatory preparation, despite being different from neoplasic pathology.
[Reference]
References
1. Correia JD, Lefebvre K, Gray DK. Surgical images: soft tissue. Transverse colonic intussusception. Can J Surg 2007;50:60-1.
2. Azar T, Berger DL. Adult intussusception. Ann Surg 1997;226:134-8.
3. Begos DG, Sandor A, Modlin IM. The diagnosis and management of adult intussusception. Am J Surg 1997;173:88-94.
4. Lorenzi M, Iroatulam AJN, Vernillo R, et al. Adult colonic intussusception caused by a malignant tumor of the transverse colon. Am Surg 1999;65:11-4.
[Author Affiliation]
A.J. Montiel-Jarqu�n, MD
General Surgeon
Instituto Mexicano del Seguro Social, UMAE, Puebla, Mexico
Competing interests: None declared.
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