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I read with great interest the image quiz “Unusal cause of crampy abdominal pain” by Yagnik. In the answer published in July-September 2010 issue of Saudi Journal of Gastroenterology. In the answer of second question, he mentioned that intussusception in adults is almost always due to pre-existing disease. I like to state here that 8-20% of cases of intussusceptions in adults are idiopathic. In a recent retrospective review of 41 patients of adult intussusceptions by Wang et al., four (9.1%) cases were idiopathic where etiologies could not be found by surgical exploration and/or pathology. These idiopathic intussusceptions in adults usually involve small intestine.