Related Experiment Videos
[Acute intestinal invagination revealing celiac disease in a 9-month-old infant]
F Lastennet1, H Piloquet, C Camby
1Clinique médicale pédiatrique, hôpital Mère et Enfant, Quai Moncousu, 44093 Nantes, France. lastennn@aol.com
Insights
Pediatric bowel intussusception can be linked to celiac disease, a rare but treatable cause. Early diagnosis through symptom recognition and a gluten-free diet can prevent recurrence.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Immunology
Background:
- Bowel intussusception in children is typically idiopathic.
- Celiac disease is a rare, indirect cause of pediatric bowel intussusception.
Observation:
- A nine-month-old infant presented with bowel intussusception.
- Symptoms included weight loss and malnutrition, with positive antibody tests for celiac disease.
- Bowel biopsy confirmed celiac disease with subtotal villous atrophy.
Findings:
- This case represents one of the earliest documented instances of bowel intussusception associated with celiac disease in an infant.
- The patient's condition improved significantly following a gluten-free diet.
Implications:
- Recognizing atypical presentations of intussusception can lead to earlier diagnosis of celiac disease.
- A gluten-free diet is crucial for managing celiac disease and preventing intussusception recurrence.
- This case highlights the importance of considering celiac disease in pediatric patients with unexplained bowel intussusception.
Unlabelled:
In most cases bowel intussusception is idiopathic in children. Indirect causes, such as celiac disease, are rare.
Case Report:
A nine-month-old girl was admitted for a bowel intussusception diagnosed by ultrasonography, yet not confirmed by barium enema. The girl underwent a thorough check up, due to a loss of weight and denutrition symptoms which evidenced immunoglobulin A anti-gliadin, immunoglobulin G anti-gliadin, immunoglobulin A anti-endomysium and antireticulin positive antibodies. Celiac disease was confirmed by bowel biopsy, which revealed a subtotal villous atrophy. Evolution was favourable under a gluten free diet.
Comments:
The description of a bowel intussusception associated with celiac disease is common. This observation appears to be the earliest case ever described: the patient was only nine months old. The initial procedure is routine: diagnosis by ultrasonography, therapeutic enema and surgery only in case of failure of medical treatment. Intussusception associated with celiac disease often presents in an atypical way: elementary forms, spontaneously resolvent and recidivious. The knowledge of this clinical set of symptoms leads to an early diagnosis of celiac disease. The gluten free diet prevents the recurrence of intussusception.