Adult Colonic Intussusception: A Focused Review of Diagnostic and Management Strategies

Adult intussusception is a rare cause of intestinal obstruction that differs markedly from the pediatric form in etiology, clinical presentation, and management. In contrast to predominantly idiopathic pediatric cases, adult intussusception is usually associated with an underlying structural lesion, particularly malignancy in colonic involvement. This narrative review summarizes current evidence regarding the epidemiology, etiologic spectrum, clinical features, diagnostic evaluation, and management of adult colo-colic and sigmoido-rectal intussusception. Clinical presentation is often nonspecific, and distal variants may mimic rectal prolapse or large bowel obstruction, contributing to delayed diagnosis. Contrast-enhanced computed tomography represents the diagnostic modality of choice, enabling the identification of lead points and associated complications. Surgical resection remains the cornerstone of treatment due to the high risk of malignancy, while nonoperative management is reserved for carefully selected cases. Improved recognition of atypical presentations and individualized, imaging-guided management are essential to optimize outcomes in this uncommon but clinically significant condition.