Grados A, Bernard F, Coquet-Reinier B, Rossi P, Bagneres D, Demoux A-L, Marciano S, Frances Y, Granel B
Service de médecine interne, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 15, France.
Rev Med Interne. 2011 Oct;32(10):628-32. doi: 10.1016/j.revmed.2011.03.334. Epub 2011 May 17.
Acute bowel intussusception is a rare manifestation in adult, which mainly involves the small intestine. Celiac disease is a frequent small bowel disease that is largely undiagnosed in adults. We report a patient in whom spontaneously regressive small bowel intussusception was the presenting manifestation of celiac disease.
A 40-year-old man was admitted for a right-sided iliac abdominal pain related to a small bowel intussusception. Laparotomy ruled out a digestive tumor. Persistence of diffuse abdominal pain associated with progressive and unexplained weight loss for several months led to the diagnosis of celiac disease, which was confirmed by the presence of specific serum autoantibodies and histological duodenal villous atrophy.
The association between small bowel intussusception and celiac disease does not seem to be fortuitous. Based on this report and the literature review, we suggest that celiac disease can favour small bowel intussusception, even in adulthood. Therefore, diagnosis of celiac disease must be discussed in the presence of unexplained intussusception.
急性肠套叠在成人中是一种罕见的表现，主要累及小肠。乳糜泻是一种常见的小肠疾病，在成人中大多未被诊断出来。我们报告一例患者，其自发性消退的小肠套叠是乳糜泻的首发表现。
一名40岁男性因与小肠套叠相关的右侧髂腹疼痛入院。剖腹探查排除了消化道肿瘤。持续数月的弥漫性腹痛伴有进行性且原因不明的体重减轻，最终诊断为乳糜泻，这通过特异性血清自身抗体的存在和十二指肠绒毛萎缩的组织学检查得以证实。
小肠套叠与乳糜泻之间的关联似乎并非偶然。基于本报告及文献综述，我们认为乳糜泻可促成小肠套叠，即使在成年期也是如此。因此，在出现不明原因的肠套叠时，必须考虑乳糜泻的诊断。
