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A rare association of intussusception and celiac disease in a child
Vanessa Pacini Inaba Fernandes1, Elizete Aparecida Lomazi2, Maria Angela Bellomo-Brandão2
1MD, MSc. Attending Physician, Pediatric Gastroenterology, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil.
Insights
Chronic intussusception in children can be linked to underlying conditions like celiac disease. Early diagnosis and dietary changes, such as a gluten-free diet, can lead to complete symptom remission and restored growth.
Area of Science:
- Pediatric Gastroenterology
- Clinical Case Study
Background:
- Intussusception is a frequent cause of pediatric intestinal obstruction, often idiopathic.
- Chronic or unusual presentations warrant thorough etiological investigation.
Purpose of the Study:
- To present a case of chronic intussusception in a child.
- To highlight celiac disease as a rare underlying cause of intussusception.
Main Methods:
- Clinical case presentation of a 3-year-old boy with prolonged gastrointestinal symptoms.
- Diagnostic workup including abdominal ultrasound and upper gastrointestinal endoscopy.
- Treatment with a gluten-free diet.
Main Results:
- Initial presentation included diarrhea, vomiting, and weight loss.
- Abdominal ultrasound revealed intussusception, which had resolved spontaneously.
- Upper gastrointestinal endoscopy led to a diagnosis of celiac disease.
- Gluten-free diet resulted in complete symptom remission and weight recovery.
Conclusions:
- Unusual intussusception presentations necessitate etiological investigation.
- Celiac disease can be an underlying cause of chronic intussusception in children.
- Dietary management is effective for celiac disease-related intussusception.
Context::
Intussusception is a common cause of acute intestinal obstruction in the pediatric population and it is normally idiopathic. Rare cases of chronic intussusception require investigation with greater attention.
Case Report::
We present a clinical case of a three-year-old boy with aqueous diarrhea, abdominal distension, vomiting and weight loss over a two-month period. During the investigation, abdominal ultrasound showed imaging of intussusception. The intraoperative findings showed the intussusception had resolved spontaneously. In further investigation, it was found that the diarrhea was malabsorptive and, after the patient underwent upper gastrointestinal endoscopy, a diagnosis of celiac disease was made. After a gluten-free diet was introduced, the patient showed complete remission of symptoms and regained weight, and normal growth was reestablished.
Conclusion::
If the clinical presentation of intussusception is unusual, etiological investigation should be undertaken. In this case report, celiac disease was the underlying cause.
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