Department of Growth and Pediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India.
BMJ Case Rep. 2020 Dec 9;13(12):e237229. doi: 10.1136/bcr-2020-237229.
Intussusception in children is mainly idiopathic or due to a viral aetiology. Occasionally, pathological lead points like Meckel diverticulum or rarely metabolic causes like hyperglycaemia can result in formation of an intussusception. We describe the case of a boy with diabetic ketoacidosis presenting with abdominal pain. Despite correction of acidosis, the gastrointestinal symptoms persisted for which an ultrasonography of the abdomen was performed. It revealed an ileo-ileal intussusception, which was confirmed by a CT scan. He underwent an exploratory laparotomy. After reduction of the intussusception, a Meckel diverticulum was found as the lead point that was then resected. We present a case of a child with type 1 diabetes having an intussusception due to Meckel diverticulum, which was probably made worse by the decreased intestinal motility due to hyperglycaemia. Intussusception should thus be suspected in patients with diabetic ketoacidosis if the pain is persistent despite correction of acidosis.
小儿肠套叠主要为特发性或病毒病因。偶尔，梅克尔憩室等病理性引发点或罕见的代谢原因如高血糖症可导致肠套叠形成。我们描述了一例糖尿病酮症酸中毒患儿以腹痛为表现的病例。尽管酸中毒得到纠正，但胃肠道症状仍持续存在，因此进行了腹部超声检查。超声检查显示回肠-回肠肠套叠，CT 扫描证实了这一诊断。患儿接受了剖腹探查术。肠套叠复位后，发现梅克尔憩室为引发点，随后将其切除。我们报告了一例 1 型糖尿病患儿发生肠套叠的病例，可能是由于高血糖导致肠道蠕动减弱而使肠套叠加重。因此，如果糖尿病酮症酸中毒患者的疼痛在酸中毒纠正后仍持续存在，应怀疑肠套叠的可能性。
