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Intussusception in a child infected with enterovirus: case report
1Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan, R.O.C.
Insights
This study reports the first case of childhood intussusception linked to enterovirus infection. Researchers identified the enterovirus genome in mesenteric lymph nodes, suggesting a potential cause for this condition.
Area of Science:
- Pediatric Surgery
- Virology
- Diagnostic Imaging
Background:
- Childhood intussusception is often idiopathic, but viral infections are suspected contributors.
- Enterovirus infections, like herpangina, are common in children.
Observation:
- A 20-month-old girl with intussusception presented with symptoms following herpangina.
- High-resolution ultrasound revealed enlarged mesenteric lymph nodes in the intussuscipiens.
- Pathologic evaluation confirmed the presence of panenterovirus genome in these lymph nodes via PCR.
Findings:
- This is the first documented case of childhood intussusception associated with enterovirus infection.
- The study provides the first sonographic evaluation of mesenteric lymph node involvement in intussusception.
- Postoperative follow-up showed resolution of mesenteric lymphoid hyperplasia.
Implications:
- This finding suggests a potential etiological link between enterovirus infection and pediatric intussusception.
- Mesenteric lymph node evaluation may be crucial in diagnosing and understanding intussusception.
- Further research is warranted to explore the role of viral infections in intussusception.
Abstract:
Most intussusceptions in childhood are idiopathic. The association of viral infection has been suspected for decades. We report a case of ileocolonic intussusception in a child during a course of enterovirus infection. A 20-month-old girl with vomiting and irritable crying of 4 days' duration was found to have intussusception by sonography. She had suffered from herpangina one week earlier. Due to her peritoneal signs, she underwent surgical manual reduction. A cluster of enlarged lymph nodes in the intussuscipiens was noted preoperatively by high resolution ultrasound. Two swollen lymph nodes were removed for pathologic evaluation and examined for a viral genome by polymerase chain reaction (PCR) amplification. Panenterovirus base pairs were confirmed on the electrophoresis print. During postoperative sonographic follow-up, significant shrinkage of previous mesenteric lymphoid hyperplasia was observed. In this article, we present the first case of childhood intussusception in associated with enterovirus infection, in which the panenterovirus genome was identified in the patient's mesenteric lymph nodes. This was also the first evaluation of the role of mesenteric lymph nodes in intussusception by high resolution sonography.