Lin S L, Shih S R, Hung Y B, Lin C Y, Lu C S
Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1999 Jun;22(2):319-23.
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.
儿童期大多数肠套叠是特发性的。病毒感染与之的关联已被怀疑数十年。我们报告一例儿童在肠道病毒感染病程中发生回结肠型肠套叠的病例。一名20个月大、持续呕吐和烦躁哭闹4天的女童经超声检查发现患有肠套叠。她一周前患过疱疹性咽峡炎。由于出现腹膜刺激征,她接受了手术手法复位。术前通过高分辨率超声在套入部发现一簇肿大的淋巴结。切除两个肿大淋巴结进行病理评估,并通过聚合酶链反应(PCR)扩增检测病毒基因组。电泳图谱上确认了肠道病毒碱基对。术后超声随访期间,观察到先前肠系膜淋巴组织增生明显缩小。在本文中,我们呈现了首例与肠道病毒感染相关的儿童肠套叠病例,其中在患者肠系膜淋巴结中鉴定出肠道病毒基因组。这也是首次通过高分辨率超声评估肠系膜淋巴结在肠套叠中的作用。