Clinical course and predictive factors of incidentally detected adult intussusceptions on CT: a retrospective cohort study

BACKGROUND: Adult intussusception is traditionally considered a surgical pathology often associated with a malignant lead point. However, the widespread use of computed tomography (CT) has led to more frequent incidental detections. We aimed to evaluate the clinical and radiological characteristics of incidentally detected adult intussusceptions and identify predictors of lesion persistence. METHODS: In this retrospective study, we reviewed 150 adult patients with incidentally detected intussusception on abdominal CT between 2020 and 2025. Demographic data, clinical history, and radiological parameters (location, segment length, lead point, and ileus) were recorded. In the subgroup of patients with follow-up imaging (n = 59), factors predicting the persistence of the intussusception were statistically analyzed. RESULTS: The mean age was 43.4 ± 18.0 years. The majority of intussusceptions were localized in the jejunum (77.3%). A pathological lead point was identified in only 11.3% of patients, and 4.7% presented with ileus. On follow-up imaging, 74.6% of the intussusceptions resolved spontaneously, while 10.2% required surgical intervention. There was no statistically significant association between the persistence of the lesion and the length of the intussuscepted segment (p = 0.184), history of malignancy (p = 0.236), or the presence of a lead point (p = 0.595). CONCLUSION: Most incidentally detected adult intussusceptions are benign, transient, jejunal predominant processes. Traditional predictive factors, such as segment length or malignancy history, are insufficient to foresee lesion persistence. A conservative approach prioritizing clinical observation should be considered in asymptomatic patients lacking a distinct lead point or ileus.