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Paediatric intussusception caused by acquired immunodeficiency syndrome-associated Kaposi sarcoma

Pratistadevi K Ramdial1, Yetish Sing, G P Hadley

  • 1Department of Anatomical Pathology, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu Natal, South Africa.

Pediatric Surgery International
|June 11, 2010
PubMed

Insights

Pediatric intussusception caused by acquired immunodeficiency syndrome (AIDS)-associated Kaposi sarcoma (KS) is rare but fatal in children. Early surgical intervention and treatment are crucial for survival.

Area of Science:

  • Pediatric Gastroenterology
  • Oncology
  • Infectious Diseases

Background:

  • Intussusception is a common surgical emergency in children.
  • Acquired immunodeficiency syndrome (AIDS)-associated Kaposi sarcoma (KS) can present with unusual manifestations in children.
  • Cutaneous KS is typically absent in pediatric AIDS-KS-associated intussusception.

Purpose of the Study:

  • To document the clinicopathological features of pediatric intussusception caused by AIDS-associated KS.
  • To highlight intussusception as a potential sentinel sign of HIV infection in children.
  • To analyze the outcomes of surgical and medical management.

Main Methods:

  • Retrospective review of clinicopathological features of six pediatric patients with AIDS-KS-associated intussusception.
  • Analysis of patient records, including clinical presentation, surgical findings, histopathology, and treatment outcomes.

Main Results:

  • Five of six patients presented with intussusception as the first sign of HIV infection.
  • All patients required bowel resection due to infarction, failed reduction, or polypoid lead points.
  • Five patients died from complications such as massive hematochezia and septic shock; one patient achieved remission with combined treatment.

Conclusions:

  • AIDS-KS-associated intussusception in children is rare, often lacks cutaneous KS, and carries a high mortality rate.
  • Surgical resection is necessary but may not prevent recurrence due to the nature of KS.
  • Timely diagnosis, surgical intervention, and comprehensive medical management including HAART and chemotherapy are vital for improving outcomes.
Abstract

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