Recalcitrant intussusception: exploring potential associations with Helicobacter pylori infection - a case report and literature review.

IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Gut Pathogens Pub Date : 2024-06-01 DOI:10.1186/s13099-024-00621-z
Kuan-Chieh Wang, Chun-Hao Chu, Che-Ming Chiang, Fu-Ruei Zeng, Ching-Wen Huang, Chien-Ming Lin
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Abstract

Background: Intussusception, a common cause of abdominal pain in children, often lacks clear underlying causes and is mostly idiopathic. Recurrence, though rare, raises clinical concerns, with rates escalating after each episode. Factors like pathological lead points and Henoch-Schönlein purpura (HSP) are associated with recurrent cases. On the other hand, the prevalence of Helicobacter pylori (H. pylori), often asymptomatic, in children has been declining. Although its infection is reported to be linked with HSP, its role in recurrent intussusception remains unexplored. Further research is needed to understand the interplay among H. pylori (culprit pathogen), HSP (trigger), and intractable intussusception so as to develop effective management strategies.

Case presentation: A two-year-old girl experienced four atypical episodes of intussusception at distinct locations, which later coincided with HSP. Despite treatment with steroids, recurrent intussusception persisted, suggesting that HSP itself was not a major cause for intractable presentations. Subsequent identification of H. pylori infection and treatment with triple therapy resulted in complete resolution of her recalcitrant intussusception.

Conclusion: This instructive case underscored a sequence wherein H. pylori infection triggered HSP, subsequently resulting in recurrent intussusception. While H. pylori infection is not common in young children, the coexistence of intractable intussusception and steroid-resistant recurrent HSP necessitates consideration of H. pylori infection as a potential underlying pathogen.

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顽固性肠套叠:探讨与幽门螺旋杆菌感染的潜在关联--病例报告和文献综述。
背景:肠套叠是导致儿童腹痛的常见原因,但往往缺乏明确的潜在病因,而且大多是特发性的。复发虽然罕见,但会引起临床关注,每次发作后复发率都会上升。病理铅点和过敏性紫癜(HSP)等因素与复发病例有关。另一方面,幽门螺旋杆菌(H. pylori)在儿童中的感染率正在下降,这种病通常没有症状。尽管有报道称幽门螺杆菌感染与 HSP 有关,但其在复发性肠套叠中的作用仍未得到探讨。我们需要进一步研究幽门螺杆菌(罪魁祸首)、HSP(诱因)和顽固性肠套叠之间的相互作用,从而制定有效的治疗策略:病例介绍:一名两岁女童经历了四次不同部位的非典型肠套叠,后来又出现了 HSP。尽管接受了类固醇治疗,但肠套叠仍反复发作,这表明 HSP 本身并不是导致顽固性肠套叠的主要原因。经过幽门螺杆菌感染鉴定和三联疗法治疗后,她的顽固性肠套叠完全治愈:这一具有启发性的病例强调了幽门螺杆菌感染引发 HSP,进而导致肠套叠复发的一系列过程。虽然幽门螺杆菌感染在幼儿中并不常见,但顽固性肠套叠和类固醇耐药的复发性 HSP 同时存在,有必要将幽门螺杆菌感染视为潜在的潜在病原体。
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来源期刊
Gut Pathogens
Gut Pathogens GASTROENTEROLOGY & HEPATOLOGY-MICROBIOLOGY
CiteScore
7.70
自引率
2.40%
发文量
43
期刊介绍: Gut Pathogens is a fast publishing, inclusive and prominent international journal which recognizes the need for a publishing platform uniquely tailored to reflect the full breadth of research in the biology and medicine of pathogens, commensals and functional microbiota of the gut. The journal publishes basic, clinical and cutting-edge research on all aspects of the above mentioned organisms including probiotic bacteria and yeasts and their products. The scope also covers the related ecology, molecular genetics, physiology and epidemiology of these microbes. The journal actively invites timely reports on the novel aspects of genomics, metagenomics, microbiota profiling and systems biology. Gut Pathogens will also consider, at the discretion of the editors, descriptive studies identifying a new genome sequence of a gut microbe or a series of related microbes (such as those obtained from new hosts, niches, settings, outbreaks and epidemics) and those obtained from single or multiple hosts at one or different time points (chronological evolution).
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