Kietkajornkul Chookiet, Vithayasai Niyada, Ratanaprakarn Warangkana, Buranakitjaroen Veera
Nephrology Division, Department of Pediatrics, Queen Sirikit National Institute of Child Health, Bangkok 10400, Thailand.
J Med Assoc Thai. 2003 Aug;86 Suppl 3:S596-9.
Gastrointestinal disturbances are encountered frequently in the course of the nephrotic syndrome but intussusception is a rare association. It may be the result of incoordinate motility and bowel wall edema.
To report a case of intussusception associated with relapsing nephrotic syndrome.
The authors reviewed the case of a 5-year-old boy who had been diagnosed as having nephrotic syndrome at Queen Sirikit National Institute of Child Health for 1 year, who later presented with nephrotic symptoms and an acute abdomen. Abdominal ultrasonography and barium enema were performed which diagnosed ileo-colic intussusception. Resection of the ileum and appendectomy were performed while the relapsing nephrotic syndrome was treated by prednisolone. The patient's recovery was excellent. Percutaneous renal biopsy was done because of the frequent relapsing condition and showed mesangial proliferative glomerulonephritis consistent with IgM nephropathy. Intussusception should be included in the differential diagnosis of relapsing nephrotic syndrome presenting with acute abdominal pain. Abdominal ultrasonography is helpful in confirming this condition.
胃肠道紊乱在肾病综合征病程中较为常见，但肠套叠与之并发则较为罕见。这可能是不协调蠕动和肠壁水肿的结果。
报告一例与复发性肾病综合征相关的肠套叠病例。
作者回顾了一名5岁男孩的病例，该男孩在诗丽吉王后国家儿童健康研究所被诊断为肾病综合征已有1年，后来出现肾病症状和急腹症。进行了腹部超声检查和钡灌肠，诊断为回结肠型肠套叠。在采用泼尼松龙治疗复发性肾病综合征的同时，进行了回肠切除术和阑尾切除术。患者恢复良好。由于病情频繁复发，进行了经皮肾活检，结果显示为系膜增生性肾小球肾炎，符合IgM肾病。对于出现急腹症的复发性肾病综合征，鉴别诊断应包括肠套叠。腹部超声检查有助于确诊此病。
