背景:肠套叠,儿童腹痛的常见原因,通常缺乏明确的根本原因,并且大多是特发性的。复发,虽然罕见,引起临床关注,每次发作后费率都在上升。病理性导联点和过敏性紫癜(HSP)等因素与复发病例有关。另一方面,幽门螺杆菌(H.pylori),通常无症状,儿童人数一直在下降。尽管据报道其感染与HSP有关,其在复发性肠套叠中的作用仍有待探索。需要进一步的研究来了解幽门螺杆菌(罪魁祸首病原体)之间的相互作用,HSP(触发器),以及顽固性肠套叠,从而制定有效的管理策略。
方法:一个两岁的女孩在不同的部位经历了四次不典型的肠套叠,后来与HSP相吻合。尽管用类固醇治疗,复发性肠套叠持续存在,这表明HSP本身并不是棘手演讲的主要原因。随后确定幽门螺杆菌感染并采用三联疗法治疗可完全缓解其顽固性肠套叠。
结论:这个有指导意义的案例强调了一个序列,其中幽门螺杆菌感染引发了HSP,随后导致复发性肠套叠。虽然幽门螺杆菌感染在幼儿中并不常见,顽固性肠套叠和激素耐药复发性HSP并存,需要考虑幽门螺杆菌感染是潜在的潜在病原体.
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.
METHODS: 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.
CONCLUSIONS: 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.