ROSH Gastrointestinal Practice Exam

In adults, which statement is true regarding intestinal intussusception?

1. Adults are more affected than children

2. Most adult intussusception cases involve the small bowel

3. Most children with intussusception have a pathologic lesion

4. The classic triad of symptoms is commonly seen in adults

The correct answer is: Most adult intussusception cases involve the small bowel

In the context of adult intussusception, it is accurate to state that most cases involve the small bowel. Intussusception occurs when a segment of the intestine telescopes into an adjacent segment, leading to obstruction and potential ischemia. In adults, this condition can often be secondary to underlying pathological lesions such as tumors or other anatomical abnormalities, but the disease process typically begins in the small intestine, particularly the ileum. This preference is attributed to the anatomy and motility of the small bowel compared to the colon in adults. Other statements provide a different understanding of the case involving intussusception. Adults are not more affected than children; in fact, intussusception is much less common in adults than in children. While it is true that many children with intussusception have a pathologic lesion as a trigger (often a lead point such as a Meckel's diverticulum), this is not as frequently the case in adults. Additionally, the classic triad of symptoms (abdominal pain, "currant jelly" stools, and a palpable mass) is more commonly associated with pediatric cases and is not as reliably present in adult cases, complicating diagnosis.