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Intussusception as a rare clinical presentation of a child with type 1 diabetes and diabetic ketoacidosis
  1. Nikhil Shah1,
  2. Vaman Khadilkar1,2,
  3. Anuradha Khadilkar1,2 and
  4. Rahul Jahagirdar3
  1. 1Department of Growth and Pediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India
  2. 2Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
  3. 3Department of Pediatrics, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharashtra, India
  1. Correspondence to Dr Anuradha Khadilkar; anuradhavkhadilkar{at}gmail.com

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.

  • diabetes
  • paediatric intensive care
  • gastrointestinal surgery

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Footnotes

  • Contributors All the listed authors- NS, AK, VK and RJ played a role in management of the patient, the conception, development, planning, execution, analysis and/or writing of the manuscript and that they all agree and accept responsibility for the contents of the manuscript submitted to BMJ case reports.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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