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Surgical treatment of recurrent intussusception induced by intestinal lymphoid hyperplasia in a child: is bowel resection always necessary? A case report. BMC Surg 2022; 22:169. [PMID: 35538469 PMCID: PMC9092808 DOI: 10.1186/s12893-022-01608-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background Intussusception recurrence (IR) induced by intestinal lymphoid hyperplasia (ILH) in children is rare, and surgical treatment is the final resort if IR is refractory to medications and non-surgical interventions. To date, only a few case reports have described surgical management of ILH-induced IR in children, all involving bowel resection regardless of whether there are bowel necrosis and perforation. Case presentation A 2-year-old boy was transferred to our department due to IR. His main complaint was abdominal pain. Color Doppler ultrasound confirmed ileocecal intussusception while no other abnormalities were found. A final diagnosis of IR with unknown causes was made. Repeated saline enema reductions and dexamethasone failed to cure the IR. Laparotomy was eventually performed after almost 10 episodes of IR. Intraoperatively, distal ileum thickening with palpable masses without bowel necrosis and perforation was noted. ILH was suspected and a biopsy of the affected intestine was performed. Histopathological analysis confirmed ILH. The intussusception was manually reduced, the terminal ileum and the ileocecal junction were fixed to the paralleled ascending colon and the posterior peritoneum respectively, and no bowel resection was performed. The postoperative recovery was uneventful and no IR was observed during over 5 years of follow-up. Conclusions As far as we are aware, this is the first report of successful surgical treatment of ILH-induced pediatric IR without bowel resection in a child. Our experience suggests bowel resection may be unnecessary if bowel necrosis and perforation are absent.
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Mari A, Sartorio MUA, Degrassi I, D’Auria E, Fiori L, Dilillo D, Agostinelli M, Pendezza E, Bosetti A, Maestri L, Pelizzo G, Zuccotti GV, Verduci E. Late-Onset Pyloric Stenosis and Intussusception With Final Diagnosis of Food Proteins' Hypersensitivity in Schaaf-Yang Syndrome: A Case Report. JPGN REPORTS 2022; 3:e202. [PMID: 37168918 PMCID: PMC10158381 DOI: 10.1097/pg9.0000000000000202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/28/2022] [Indexed: 05/13/2023]
Abstract
Schaaf-Yang syndrome (SYS) is a rare neurodevelopmental disorder whose clinical spectrum includes neurodevelopment delay, dysmorphic features, and gastrointestinal symptoms such as feeding difficulties, gastroesophageal reflux, and chronic constipation. Given the small number of patients diagnosed with this syndrome, our aim is to describe novel clinical features that have not yet been reported. The patient we are describing is a 14-year-old male affected by a severe form of SYS. Initial clinical presentation included respiratory distress at birth, feeding difficulties, and neurodevelopmental delay. Since the age of 8 months, he had been tube fed with a semi-elemental formula, and this was well tolerated. At 9 years of age, the pathological mutation (variant p.Val701fs in MAGEL2 gene) associated with SYS was diagnosed. At 13 years of age, he presented severe gastrointestinal symptoms associated to progressive feeding difficulties. He also suffered from recurrent pancreatitis, late-onset pyloric stenosis and intussusception. Histology showed duodenal villous atrophy with a negative serology for celiac disease. Food protein's hypersensitivity was diagnosed and symptoms resolved after starting an elemental formula.
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Affiliation(s)
- Alessandra Mari
- From the Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, Milan, Italy
| | - Marco Ugo Andrea Sartorio
- From the Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, Milan, Italy
| | - Irene Degrassi
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, Milan, Italy
| | - Enza D’Auria
- From the Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, Milan, Italy
| | - Laura Fiori
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, Milan, Italy
| | - Dario Dilillo
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, Milan, Italy
| | - Marta Agostinelli
- From the Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, Milan, Italy
| | - Erica Pendezza
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, Milan, Italy
| | - Alessandra Bosetti
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, Milan, Italy
| | - Luciano Maestri
- Department of Pediatric Surgery, Vittore Buzzi Children’s Hospital, Milan, Italy
| | - Gloria Pelizzo
- Department of Pediatric Surgery, Vittore Buzzi Children’s Hospital, Milan, University of Milan, Milan, Italy
| | - Gian Vincenzo Zuccotti
- From the Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, Milan, Italy
| | - Elvira Verduci
- From the Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, Milan, Italy
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Aydin E, Beşer OF, Ozek E, Sazak S, Duras E. Is There a Causal Relationship between Intussusception and Food Allergy? CHILDREN (BASEL, SWITZERLAND) 2017; 4:E89. [PMID: 29048383 PMCID: PMC5664019 DOI: 10.3390/children4100089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/03/2017] [Accepted: 10/17/2017] [Indexed: 11/25/2022]
Abstract
Although intussusception and food allergy are common health problems in childhood, the relation between these two diseases remain obscure. The aim of this study is to investigate the relationship between food allergy and intussusception, and the factors associated with both. Patients diagnosed with intussusception by the Brighton Collaboration Intussusception Working Group criteria were prospectively investigated for food allergy per the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Guideline. They were analyzed per demographic features, clinical, physical and laboratory findings. There were eight (38.1%) patients diagnosed with food allergy, while 13 (61.9%) patients were non-allergic. The mean number of days of presenting symptoms was 1.13 days in the allergy group and 7.85 days in the non-allergy group. The mean number of intussusception attacks was 1.63 in the allergy group while 1 in the non-allergy group (p < 0.05, relative risk (RR) = 2.6). In the allergy group, one (13%) patient was followed up, six (75%) patients were reduced with pneumatic and one (13%) patient reduced manually. In the non-allergy group, four (31%) patients were followed up, six (46%) patients were reduced with pneumotic, one (7%) patient was reduced manually, and resection anastomosis was performed in two (15%) patients. Food allergy is an unrecognized associated factor for intussusception patients, which increases the risk for recurrence. Due to the small patient population, these results should be interpreted with caution.
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Affiliation(s)
- Emrah Aydin
- Department of Pediatric Surgery, Bahcelievler State Hospital, Kocasinan Karadeniz Mah. No. 48 Bahcelievler, Istanbul 34186, Turkey.
| | - Omer F Beşer
- Department of Pediatric Gastroenterology, Okmeydani Education & Training Hospital, Istanbul 34384, Turkey.
| | - Esra Ozek
- Department of Pediatric Allergy and Immunology, Okmeydani Education & Training Hospital, Istanbul 34384, Turkey.
| | - Soner Sazak
- Department of Pediatrics, Okmeydani Education & Training Hospital, Istanbul 34384, Turkey.
| | - Ensar Duras
- Department of Pediatrics, Okmeydani Education & Training Hospital, Istanbul 34384, Turkey.
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Taliancich-Klinger CL, Byrd CT, Bedore LM. The disfluent speech of a Spanish-English bilingual child who stutters. CLINICAL LINGUISTICS & PHONETICS 2013; 27:888-904. [PMID: 23944959 DOI: 10.3109/02699206.2013.813076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study provides a detailed description of the disfluent speech behaviours produced by a 6;1-year-old bilingual Spanish-English speaking female with confirmed stuttering. Eight language samples across different contexts (narratives and conversations) with the clinician in English and Spanish and the parent in Spanish were analysed. Language samples were transcribed in the Systematic Analysis of Language Transcripts programme and coded for types of disfluencies based on guidelines for monolingual English speakers. Similarities and differences were noted in speech disfluencies produced in English as compared Spanish. Overall, the participant was more disfluent in English across both her narrative and her conversational output. However, she produced more stuttering-like disfluencies in her Spanish narrative sample than her English narrative sample. Conversely, she produced more nonstuttering-like disfluencies in her English than her Spanish narrative sample. These findings suggest stuttering specific as well as language specific contributors to the fluency breakdowns that characterize the speech output of a bilingual Spanish English child who stutters.
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Affiliation(s)
- Casey L Taliancich-Klinger
- Department of Communication Sciences and Disorders, The University of Texas at Austin , Austin, TX , USA and
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