Intussusception as a rare clinical presentation of a child with type 1 diabetes and diabetic ketoacidosis

BMJ Case Rep. 2020 Dec 9;13(12):e237229. doi: 10.1136/bcr-2020-237229.

Abstract

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.

Keywords: diabetes; gastrointestinal surgery; paediatric intensive care.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Child
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetic Ketoacidosis / complications*
  • Humans
  • Intussusception / etiology*
  • Intussusception / surgery
  • Laparotomy
  • Male
  • Meckel Diverticulum / diagnostic imaging*
  • Tomography, X-Ray Computed
  • Ultrasonography