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Query: UMLS:C0011854 (type 1 diabetes)
 20,749 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence of functional intussusception is extremely rare in adults. A 23-year-old woman, previously diagnosed with type 1 diabetes mellitus (DM), complained of colicky abdominal pain associated with vomiting of 1-day duration. Currant jelly stool was observed. Irrespective of hydration and intravenous insulin injection under the diagnosis of diabetic ketoacidosis (DKA), her abdominal pain and laboratory parameters did not improve. Abdominal computerized tomography (CT) revealed a jejunojejunal intussusception. We maintained large-volume fluid administration, and her abdominal pain began to subside. The stool culture was positive for Vibrio parahaemolyticus. We confirm the intussusception that was resolved by supportive management without surgical intervention in a patient with gastroenteritis and diabetic ketoacidosis.
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PMID:Intussusception in a young female with Vibrio gastroenteritis and diabetic ketoacidosis. 1730 11

BACKGROUND Intussusception in adults (AI) accounts for 1% of all cases of bowel obstruction. While pediatric intussusception is well known and almost always idiopathic, an underlying cause is usually found in adults. Indication for surgical treatment and intussusception reduction before resection remain controversial in AI. Here, we present an uncommon case of an immunocompromised patient who had multiple intussusceptions. CASE REPORT A 59-year-old woman, who had received a kidney-pancreas transplant for type 1 diabetes with end-stage renal failure, was admitted to our Intensive Care Unit for septic shock of suspected pulmonary origin. A thoraco-abdominal CT scan demonstrated signs of bilateral pneumonia and multiple abdominal intussusceptions, for which she underwent surgery. Four intestinal intussusceptions were found. Manual desinvagination was performed without bowel resection. After surgery, the patient presented a new bowel obstruction, requiring a second surgery, showing recurrence of 1 intussusception. Segmental resection was indicated, but not performed because of the septic shock, requiring high-dose noradrenalin. The patient progressed toward multi-organ failure, leading to her death a few days later. An autopsy revealed that multiple adenomas were responsible for the intussusceptions. CONCLUSIONS This case confirms that AI is rarely a spontaneous disease and that the therapeutic strategy should be planned accordingly. There is currently no systematic approach for AI, and guidelines are needed to improve its management.
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PMID:Intussusception in an Immunocompromised Patient: A Case Report and Review of the Literature. 3193 49

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.
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PMID:Intussusception as a rare clinical presentation of a child with type 1 diabetes and diabetic ketoacidosis. 3329 84