Purpose

CT and MRI have a high diagnostic accuracy for identifying small bowel intussusception. As small bowel intussusception can be associated with a neoplastic lead point, patients frequently undergo further investigation to distinguish physiological intussusception from that caused by a mass lesion. Video capsule endoscopy (VCE) is a non-invasive investigation that can be used to identify lesions that may be acting as a lead point.

We sought to study the prevalence of small bowel mass lesions in patients undergoing VCE to investigate radiologically-identified intussusception.

Material and methods

We searched the reports of VCE studies between 2007 and 2018 (1438 patients) for terms related to intussusception. Patients that underwent VCE for radiological intussusception had their imaging/reports reviewed by a GI Imaging Fellow and VCE images reviewed by a Consultant Gastroenterologist.

Results

Our search identified 24 patients, 14 of which had radiological small bowel intussusception. Radiological small bowel intussusception correlated with two VCE studies demonstrating significant abnormalities. In one patient, the VCE had indeterminate findings. A subsequent device-assisted endoscopy was undertaken and no lesion was found that could have accounted for intussusception. In the other patient, intussusception was present but no lesion was seen.

Conclusion

Our study demonstrates a poor correlation between radiological small bowel intussusception in adults and findings at VCE that could represent a lead point. We favour most adult radiological small bowel intussusceptions are unrelated to significant lead point pathology. Our study will support our multidisciplinary team to dismiss these radiology findings in the absence of a high index of clinical suspicion.