[Acute intestinal invagination revealing celiac disease in a 9-month-old infant]

Abstract

In most cases bowel intussusception is idiopathic in children. Indirect causes, such as celiac disease, are rare.

Case report: A nine-month-old girl was admitted for a bowel intussusception diagnosed by ultrasonography, yet not confirmed by barium enema. The girl underwent a thorough check up, due to a loss of weight and denutrition symptoms which evidenced immunoglobulin A anti-gliadin, immunoglobulin G anti-gliadin, immunoglobulin A anti-endomysium and antireticulin positive antibodies. Celiac disease was confirmed by bowel biopsy, which revealed a subtotal villous atrophy. Evolution was favourable under a gluten free diet.

Comments: The description of a bowel intussusception associated with celiac disease is common. This observation appears to be the earliest case ever described: the patient was only nine months old. The initial procedure is routine: diagnosis by ultrasonography, therapeutic enema and surgery only in case of failure of medical treatment. Intussusception associated with celiac disease often presents in an atypical way: elementary forms, spontaneously resolvent and recidivious. The knowledge of this clinical set of symptoms leads to an early diagnosis of celiac disease. The gluten free diet prevents the recurrence of intussusception.