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LETTER TO THE EDITOR Table of Contents   
Year : 2009  |  Volume : 6  |  Issue : 2  |  Page : 131
Acute intussusception due to intestinal Kaposi's sarcoma in an infant


Department of Paediatric Surgery, Teaching Hospital Treichville, Abidjan - Cote D'ivoire

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Date of Web Publication29-Jul-2009
 

How to cite this article:
Sanni R B, Nandiolo R, Coulibaly Diaoudia MF, Vodi L, Mobiot M L. Acute intussusception due to intestinal Kaposi's sarcoma in an infant. Afr J Paediatr Surg 2009;6:131

How to cite this URL:
Sanni R B, Nandiolo R, Coulibaly Diaoudia MF, Vodi L, Mobiot M L. Acute intussusception due to intestinal Kaposi's sarcoma in an infant. Afr J Paediatr Surg [serial online] 2009 [cited 2020 Apr 9];6:131. Available from: http://www.afrjpaedsurg.org/text.asp?2009/6/2/131/54784
Sir,

Acute intussusception in children is idiopathic in almost 90% of the cases . [1] We recently received an infant with intussusception in which Kaposi's sarcoma was the lead point.

The 5-month - old male infant had been managed by a paediatrician on account of abdominal distension for 6 days and was later referred to paediatric surgery. His general condition was very poor. He was dehydrated, weighted 5 kg 400 g, with blood pressure of about 90/40 mmHg, temperature 38 and pulse 100 b/min. The abdomen was distended, with weaves of persistaltis. There was a vague tenderness, but no mass could be palpated because the abdomen was tense. Anorectal examination revealed mucoid stools and a plain abdominal radiograph showed air fluid levels.

The patient was resuscitated and had laparotomy. The intraoperative findings were a necrotic ileo colic intussusception with haemoperitoneum. The gangrenous bowel was resected with end - to - end anastomosis. There was a fusiform lead point that was histologically confirmed to be Kaposi's sarcoma.

He developed anastomotic dehiscence 7 days later that necessitated reexploration and reanastomosis. Ten days after the second surgery, he developed bowel obstruction that warranted a second reexploration during which a terminal ileostomy was performed. He had an uneventful recovery and was discharged after 1 week. After 2 weeks of follow - up, he was lost to follow-up until 6 years later when he presented with clinical signs and laboratory proofs of full - blown acquired immunodeficiency syndrome. The child died 10 days later.

The intestinal Kaposi's sarcoma is exceptional in children, unlike the 34% incidence of Kaposi in human immunodeficiency virus ( HIV )- positive adults. [2] Unlike bowel obstruction, intestinal perforation or an appendicitis caused by Kaposi , which are frequently reported in HIV - positive adults , [4],[5],[6] only one case of intussusception with an intestinal Kaposi's sarcoma as the leading point has been described. [3] The finding in this report is a pointer that the intestinal Kaposi's sarcoma-related complications are present in HIV - positive children also.

This communication, therefore, is a call for vigilance among paediatric surgeons that intussusception may be caused by Kaposi's disease, particularly in areas where HIV is endemic.

 
   References Top

1.Ko SF, Lee TY, Ng SH, Wan YL, Chen MC, Tiao MM, et al . Small Bowel intussusception in symptomatic pediatric patients: Experiences with 19 surgically proven cases. World J Surg 2002;26:438-43.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Ravera M, Reggiori A, Cocozza E, Andreata M, Cantia F. Kaposi's Sarcoma and Aids in Uganda: Its frequency and gastro intestinal distribution ital J gastro enterol 1994;26:329-33.  Back to cited text no. 2    
3.Gulick RM. Abdominal pain in a man with HIV ,TB and Kaposi sarcoma AIDS Clin care 1997;9:40-4.  Back to cited text no. 3    
4.Wheeler DW, Baigrie RJ. Palliative surgery for acute bowel obstruction causes bu Kaposi sarcoma in a patient with AIDS. Int J Clin Pract 2003;57:347-8.  Back to cited text no. 4  [PUBMED]  
5.Yoshida EM, Chan NH, Chan-yan C, Baird RM. Perforation of the jejunum secondary to AIDS- Rectal gastro intestinal Kaposi's sarcoma Can Jgastro enterol, 1997 Jan-Feb; 11: 38-40.  Back to cited text no. 5    
6.Chetty R, Arendse MP. Gastro-intestinal Kaposi's sarcoma, with special reference to appendix. S Afr J Surg 1999;37:9-11.  Back to cited text no. 6  [PUBMED]  

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Correspondence Address:
R Bankole Sanni
18 B.P. 1794 Abidjan 18

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0189-6725.54784

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