Ramdial Pratistadevi K, Sing Yetish, Hadley G P, Chotey Nivesh A, Mahlakwane Mabitsela S, Singh Bhugwan
Department of Anatomical Pathology, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu Natal, South Africa.
Pediatr Surg Int. 2010 Aug;26(8):783-7. doi: 10.1007/s00383-010-2625-2. Epub 2010 Jun 10.
To document the clinicopathological features of paediatric intussusception caused by acquired immunodeficiency syndrome (AIDS)-associated Kaposi sarcoma (KS).
Clinicopathological features of six patients with AIDS-KS-associated intussusception were obtained retrospectively from departmental and hospital records.
Six debilitated male children, without cutaneous KS, were presented with abdominal pain and vomiting for >1 week. Intussusception was the sentinel of HIV infection in five patients. One patient had been on HAART for 13 months. Three patients each had ileal and ileocolic intussusceptions; two had recurrent intussusception. Bowel resection was performed because of failed reduction, infarction and polypoid lead points in all patients, in addition to perforation and peritonitis in three. Five patients died, the immediate cause being massive hematochezia from anorectal KS and/or septic shock. One patient, who received post-surgical chemotherapy and HAART, is currently in remission. Pathologic examination confirmed intussusception due to KS.
AIDS-KS-associated intussusception occurred without cutaneous KS. Resection of the infarcted segment may relieve the presenting obstruction, but recurrent intussusception may occur because every elevated KS is a potential lead point. AIDS-KS-I is rare but fatal in children, unless timely surgical intervention, optimal histopathological diagnosis, and appropriate medical management, including HAART and chemotherapy, are facilitated.
记录获得性免疫缺陷综合征（AIDS）相关的卡波西肉瘤（KS）所致小儿肠套叠的临床病理特征。
回顾性分析6例AIDS-KS相关性肠套叠患者的科室及医院记录，获取其临床病理特征。
6例虚弱男童，无皮肤KS表现，均有腹痛及呕吐，症状持续超过1周。5例患者中，肠套叠是HIV感染的首发表现。1例患者已接受高效抗逆转录病毒治疗（HAART）13个月。3例患者分别发生回肠及回结肠型肠套叠；2例出现复发性肠套叠。所有患者均因复位失败、肠梗死及息肉样套入点而行肠切除，3例还合并肠穿孔及腹膜炎。5例患者死亡，直接死因是肛门直肠KS导致的大量便血和/或感染性休克。1例患者接受了术后化疗及HAART，目前病情缓解。病理检查证实肠套叠由KS引起。
AIDS-KS相关性肠套叠可在无皮肤KS表现的情况下发生。切除梗死肠段可缓解当前梗阻，但由于每个隆起的KS都是潜在的套入点，复发性肠套叠仍可能发生。AIDS-KS-I在儿童中罕见但致命，除非能及时进行手术干预、获得最佳组织病理学诊断并给予包括HAART及化疗在内的适当药物治疗。
