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

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 assoc...

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Bibliographic Details
Published in:Gut pathogens 2024-06, Vol.16 (1), p.28
Main Authors: Wang, Kuan-Chieh, Chu, Chun-Hao, Chiang, Che-Ming, Zeng, Fu-Ruei, Huang, Ching-Wen, Lin, Chien-Ming
Format: Article
Language:English
Subjects:
Abdomen
Antigens
Case Report
Case reports
Children
Children & youth
Clinical medicine
Coexistence
Etiology
Food allergies
Health aspects
Helicobacter infections
Helicobacter pylori
Infection
Infections
Intestinal obstruction
Intestines
Intussusception
Literature reviews
Medical colleges
Metronidazole
Pain
Pathogens
Purpura
Recurrent infection
Schonlein-Henoch purpura
Steroid hormones
Steroids
Tumor necrosis factor-TNF
Viral infections
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Summary: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. 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. 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.
ISSN:1757-4749
1757-4749
DOI:10.1186/s13099-024-00621-z