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Intussusception in an adult patient with severe hyperglycaemia--a case report
S I McFarlane1, K Byrne, J Shin
1Division of Endocrinology, Diabetes and Hypertension, Department of Medicine at State University of New York, Health Science Center at Brooklyn/Kings County Hospital, 11203, USA. smcfarlane@netmail.hscbklyn.edu
Aims:
To report a case of adult intussusception associated with and possibly induced by acute hyperglycaemia.
Methods:
We present the first case report of adult intussusception with severe hyperglycaemia. Clinical and laboratory data together with radiological findings are presented with a brief review of the literature.
Results:
A 20-year-old man with no past medical history presented with abdominal pain for 2 days. The patient was severely hyperglycaemic with blood glucose of 72.7 mmol/l (normal 3.3-6.1 mmol/l), a pH of 7.2 and serum potassium of 6.5 mmol/l (normal 3.5-5.0 mmol/l). He had a computed tomography (CT) scan of the abdomen that revealed small bowel intussusception. Upon treatment of his hyperglycaemia, the patient's abdominal pain completely resolved. Follow up abdominal CT revealed complete resolution of the previously detected intussusception.
Conclusion:
Clinicians should be aware of the potential for the occurrence of intussusception in severely hyperglycaemic patients. Correction of hyperglycaemia could lead to resolution of the intussusception without surgical intervention. Possible effects of hyperkalaemia and/or acidosis on gastrointestinal motility should also be considered.