Adult intussusception is a rare cause of intestinal obstruction, accounting for 1–5% of cases. Unlike pediatric intussusception, it is frequently associated with a pathological lead point, with malignancy reported in up to 30–65% of colonic cases in Western series. However, data from sub-Saharan Africa remain limited, and the applicability of these patterns in resource-limited settings is uncertain. This study aimed to describe the clinical presentation, diagnostic approach, surgical management, and histopathological findings of adult intussusception at a tertiary referral center in Northwest Ethiopia. A retrospective case series was conducted at the University of Gondar Comprehensive Specialized Hospital, including all adult patients (≥18 years) with surgically confirmed intussusception between January 2018 and December 2025. Data were collected from medical records, operative reports, and histopathology results. Descriptive statistics were performed, and subgroup comparisons were analyzed using Fisher’s exact test. A total of 26 patients were included, with a mean age of 46.2 years (SD ± 14.1), and a male predominance (69.2%). Abdominal pain was universal (100%), while nausea and vomiting occurred in 88.5% of patients. The mean duration of symptoms was 9.7 days (SD ± 9.3). Ultrasound was the primary diagnostic modality in 80.8% of cases, demonstrating the characteristic target sign in the majority. Ileocolic intussusception was the most common subtype (65.4%), followed by enteric (26.9%) and colocolic (7.7%). Bowel viability was preserved in 84.6% of patients. Surgical resection was performed in 80.8%, most commonly right hemicolectomy (66.7% of resections). A pathological lead point was identified in 61.5% of cases. Inflammatory lesions (37.5%) and lipomas (31.3%) were the most common etiologies. Malignancy was identified in only one patient (3.8% of the cohort). Postoperative complications occurred in one patient (3.8%), with no 30-day mortality. The mean hospital stay was 6.3 days (SD ± 1.5). Adult intussusception in this Ethiopian cohort demonstrates a clinical and etiological profile that differs from classical Western descriptions. The low prevalence of malignancy and predominance of benign and inflammatory lead points challenge the universal applicability of established management paradigms. Ultrasound proved to be an effective primary diagnostic modality in this resource-limited setting. Favorable surgical outcomes were observed, with minimal morbidity and no mortality. These findings highlight the importance of context-specific evidence and underscore the need for larger multicenter studies in sub-Saharan Africa.
Molla et al. (Wed,) studied this question.