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Case Reports
. 2021 Jan 13:14:1179547620986152.
doi: 10.1177/1179547620986152. eCollection 2021.

Atypical Presentation of Celiac Disease: Recurrent Acute Small Bowel Obstruction

El Qadiry R  1 , Lalaoui A  1 , Nassih H  1 , Aitsab I  1 , Bourrahouat A  1
Affiliations
Case Reports

Atypical Presentation of Celiac Disease: Recurrent Acute Small Bowel Obstruction

El Qadiry R et al. Clin Med Insights Case Rep. .

Abstract

Context: Intussusception is the most common cause of small bowel obstruction in children under 4 years of age. Intussusception is not a widely recognized complication of celiac disease.

Case report: We present a clinical case of a 23-month-old boy with a 1-month history of watery diarrhea complicated by 2 episodes of intestinal obstruction, both had required surgery. He presented with acute and severe abdominal distention with bilious vomiting, and an appearance of intussusception on abdominal ultrasound. Upon further investigation, the diarrhea was found to be malabsorptive. The diagnosis of celiac disease was confirmed by the presence of specific serum autoantibodies (IgA Tissue transglutaminase and endomysium Antibodies >200 UI/ml with normal serum IgA level). He started a gluten-free diet and his symptoms were almost completely resolved.

Conclusion: Recurrent intussusception may be associated with celiac disease, so celiac serology is recommended in children with recurrent intussusceptions. However, intestinal tuberculosis and lymphoma associated with enteropathy should be considered in the differential diagnosis. Intussusception in celiac disease is usually transient and should be managed expectantly rather than early surgical reduction.

Keywords: Recurrent small bowel obstruction; celiac disease; intussusception.

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Conflict of interest statement

Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
multiple abnormal hydroaeric levels in abdominal x-rays.
Figure 2.
Figure 2.
Abdominal ultrasound image showing an intussusception in the right hypochondrium.
Figure 3.
Figure 3.
Abdominal ultrasound image showing an intussusception in the right iliac region.
See this image and copyright information in PMC

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