Adult intussusception is rare. It represents only 5% of all intussusceptions and 1% of bowel obstruction. Clinical presentations are usually variable with a variety of acute, intermittent and chronic symptoms. It is associated with an underlying pathologic process in 90% of cases. A lack of Malaysia data prompted review of the Sarawak experience with this uncommon entity, focusing on the clinical features, diagnostic procedure and treatment. During the last 5 years, there were 14 cases of surgically proven adult intussusception. Mean age was 45.9 years. There were 9 enteric and 5 colonic intussusceptions. Ninety-three percent of the intussusceptions were associated with a pathologic lesion. Thirty-three percent of the enteric lesions were malignant and 67% were benign. Eighty percent of the colonic lesions were malignant and 20% were benign. Computed tomography scan has a good diagnostic accuracy of 83% and should be considered for all patients with nonspecific abdominal symptoms or suspected bowel obstruction. Treatment of choice for colonic intussusception in adults is en bloc resection without reduction whenever possible, whereas a more selective approach for enteric lesions.
This paper describes the first Malaysian case of oesophagostomiasis. The patient was an 8-year-old Malay boy who presented to Ipoh General Hospital, Perak with abdominal pain and weight loss. Examination revealed multiple cavitated pseudotumours of the colon. A hemicolectomy was performed. Examination of the lesions revealed Oesophagostomum worms in the necrotic centres. The differential diagnoses and the pathology caused by Oesophagostomum are discussed. A brief review of the available literature is presented.