Association of Intussusception and Celiac Disease in Adults

Introduction Intussusception (IS) is rare in adults. However, the more frequent use of cross-sectional imaging has resulted in an increase in its detection. Because of the reported association with celiac disease, we determined the prevalence of IS among a cohort with celiac disease. Methods An anon...

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Bibliographic Details
Published in:Digestive diseases and sciences 2010-10, Vol.55 (10), p.2899-2903
Main Authors: Gonda, Tamas A, Khan, Sharif-Uz-Zaman, Cheng, Jian, Lewis, Suzanne K, Rubin, Moshe, Green, Peter H. R
Format: Article
Language:English
Subjects:
Abdominal Pain - epidemiology
Abdominal Pain - pathology
Adenocarcinoma - epidemiology
Adenocarcinoma - pathology
Adult
Adults
Atrophy
Biochemistry
Biological and medical sciences
Biopsy
Capsule Endoscopy
Celiac disease
Celiac Disease - epidemiology
Celiac Disease - pathology
Chi-Square Distribution
Colorectal cancer
Databases, Factual
Feeding. Feeding behavior
Female
Follow-Up Studies
Fundamental and applied biological sciences. Psychology
Gastroenterology
Gastroenterology. Liver. Pancreas. Abdomen
Hepatology
Humans
Incidental Findings
Intestinal Neoplasms - epidemiology
Intestinal Neoplasms - pathology
Intussusception - epidemiology
Intussusception - pathology
Male
Medical research
Medical sciences
Medicine
Medicine & Public Health
Medicine, Experimental
Middle Aged
Oncology
Original Article
Other diseases. Semiology
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Transplant Surgery
Vertebrates: anatomy and physiology, studies on body, several organs or systems
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Summary:Introduction Intussusception (IS) is rare in adults. However, the more frequent use of cross-sectional imaging has resulted in an increase in its detection. Because of the reported association with celiac disease, we determined the prevalence of IS among a cohort with celiac disease. Methods An anonymized prospectively maintained celiac disease database and radiological database were reviewed. Results Of a total of 880 patients, 14 (age 47 ± 17.5 years; 50% female) had IS that was detected by CT in 10, capsule endoscopy in three, and barium studies in two. The reason for evaluation was abdominal pain in 78% (11/14), whereas in the remainder (3/14) were incidental. IS was the initial manifestation of celiac disease in 57% (8/14). Two patients were found to have lead-point intussusceptions and both had small-bowel adenocarcinoma, and 10/14 had severe villous atrophy (subtotal or total). Among those with established celiac disease, IS was detected early, within 3 years of diagnosis. Follow-up was available for 11 patients, 9 of who adhered strictly to a gluten-free diet, and six had no recurrence. Among all the patients diagnosed with IS on radiologic studies at our institution, 45 were considered to have idiopathic IS. Only two of these patients had evaluation for celiac disease. Conclusion IS occurs in celiac disease. It may be the initial presentation and is associated with abdominal pain. Adenocarcinoma needs to be excluded. The majority of patients do not have recurrent symptoms after adherence to a gluten-free diet. Celiac disease should be considered more frequently when IS is encountered.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-009-1086-8