In the case report by Gao et al. (1), a 32-year-old male presented with pain and distention in the lower left quadrant following a liver transplant for liver failure and cirrhosis. Initial CT scans showed proximal enterostenosis, but symptoms of constipation gradually became more severe. Another CT scan was completed 4 days later, and an exploratory laparoscopy was performed, indicating antegrade intussusception, where the proximal bowel invaginated itself into the distal bowel. Adhesion removal and a simple reduction were completed, and a small incision was made to ensure local adhesion restoration. The serosa was sutured integrally. Reported pain and distention decreased gradually following the procedure, and the patient was discharged 9 days later, with no symptoms at a 2-month follow-up.

Laparoscopy is becoming a more favorable method for surgical treatment of intussusception and causes less tissue damage and immune responses compared to an open laparotomy (2). Moreover, laparoscopy decreases the duration of hospital stay and the time to first food intake (3). Post-operative complication rates are similar between laparotomy and laparoscopy, but the complications from laparoscopy are often more severe (i.e., perforation) (3).

Surgical options, including laparotomy or laparoscopy, remains the main treatment plan for adult intussusception, although the specifics of the interventions vary. Surgical interventions for intussusception tend to include one of the five following procedures: resection without reduction, reduction followed by resection, reduction only, enterotomy and mass excision, and negative exploration (4). Most studies support case-by-case determinations of whether reductions should be performed, while there is more limited support for resection without reduction. Resection without reduction helps prevent the potential risks of implantation metastasis in intussusception cases involving cancerous tumors. Overall, the best surgical method depends on the location of the intussusception. In enteric intussusception, reduction followed by resection is most successful. In colonic intussusception, resection alone is most effective. Ileocolic intussusception has an intermediate location and requires a more selective, combined approach (4).

There are also non-invasive and non-surgical treatments for intussusceptions, including hydrostatic, pneumatic, and gas enemas under ultrasound or fluoroscopy. In addition, colonoscopy has been considered as a treatment option. Unless there is an imminent indication for surgery, as in emergency cases, it is frequently recommended that diagnostic evaluation and more conservative, non-surgical treatment options be utilized, especially in pediatric populations (4, 5). Ultrasound-guided hydrostatic reductions can serve as a safer, non-operative treatment for intussusceptions (6). Hydrostatic reductions have similar safety and efficacy compared to pneumatic reduction, and ultrasound guided intussusception reduction should continue to be evaluated, as it does not require radiation exposure (7). Colonoscopy has also successfully reversed invaginations in two-thirds of pediatric patients (8) and has also been effective in adult patients (9).