Paediatric Intensive Care Unit, Children's Hospital of Tunis, Tunis, Tunisia.
J Pediatr Surg. 2011 Feb;46(2):e9-11. doi: 10.1016/j.jpedsurg.2010.09.011.
Intestinal involvement in toxic epidermal necrolysis (TEN) has been identified only rarely. We report a case of TEN complicated by small bowel intussusception. The patient was a previously healthy 8-year-old boy who presented with TEN and extensive lesions, including up to 40% of the body surface area as well as conjunctival, oropharyngeal, respiratory, and genital mucosa. Rapidly after the onset of a constant rate of enteral feeding, he developed bilious vomiting, diarrhea, and significant abdominal distension. Abdominal sonography showed a small bowel intussusception. At abdominal exploration, an ileoileal intussusception was observed with a viable but inflamed bowel wall. Manual reduction was performed. During the postoperative clinical course, the patient was managed with total parenteral nutrition and local care of the skin and mucous membranes. Enteral feeding was introduced on the sixth postoperative day, and the child left the hospital 15 days after his admission. The association of TEN and small bowel intussusception has not been previously reported in the literature.
肠毒性表皮坏死松解症（TEN）合并小肠套叠罕见。我们报告一例 TEN 合并小肠套叠。患者为既往健康 8 岁男孩，表现为 TEN 及广泛皮损，累及面积达 40%，包括结膜、口咽、呼吸及生殖器黏膜。在开始持续匀速肠内喂养后不久，他出现胆汁性呕吐、腹泻及显著腹胀。腹部超声显示小肠套叠。腹部探查时发现回肠回肠套叠，肠壁存活但有炎症。行手法复位。术后临床过程中，患者接受全肠外营养和皮肤及黏膜局部护理。术后第 6 天开始肠内喂养，入院 15 天后出院。TEN 合并小肠套叠在文献中尚无报道。
