Clinical Characteristics of Intussusception in Children: Comparison between Small Bowel and Large Bowel Type / 대한소화기학회지

BACKGROUND/AIMS: Small bowel intussusception is rarely diagnosed in children. And its studies have not been frequently reported. While surgical treatment has been considered as standard treatment in small bowel intussusception in adult population, spontaneous reduction of it is increasingly reported recently. Therefore, we analyzed the clinical features and outcome of small bowel intussusception in children compared with ileocolic intussusception. METHODS: 95 children with the diagnosis of intussusception who visited Sanggye-Paik hospital were included in this study between March 2000 and December 2003. We retrospectively reviewed the clinical records and imaging findings. Ultrasonographic studies were performed by an experienced pediatric radiology staff using SEQUOIA 512 machine (probe 4-8 MHz). RESULTS: A total of 80 patients with ileocolic intussusception (41 male, 39 female) and 15 patients (11 male, 4 female) with small bowel intussusception were diagnosed. Children with small bowel intussusception were older than ileocolic intussusception (mean age: 40 months vs. 16 months). The presenting symptoms of small bowel intussusception were vomiting, irritability, abdominal pain, bloody stool, and abdominal mass in order and were not different with those of ileocolic intussusception. While in ileocolic intussusception group, reduction was done by gastrograffin enema (73.8%), spontaneous reduction (0%) and surgical reduction (26.3%), spontaneous reduction was done in 73.3% and surgical reduction in 20% in small bowel intussusception group. CONCLUSIONS: Small bowel intussusception in children occurred in older age than ileocolic intussusception and was reduced spontaneously in large proportion.

One Case of Childhood Adrenoleukodystrophy Involving the White Matter of the Frontal Lobe / 대한소아신경학회지

Childhood adrenoleukodystrophy is a progressive, demyelinating disease of the white matter. Although it is sometimes misdiagnosed as a psychiatric disorder, it can be reliably confirmed by magnetic resonance imaging(MRI) and biochemical study. We experienced a case of adrenoleukodystrophy in a ten-year-old boy, who initially presented a behavioral disorder and mild speech disability. His brain MRI was compatible with leukodystrophy but it was atypically involved in both of the frontal regions. Childhood adrenoleukodystrophy could be confirmed by the elevated level of plasma hexacosanoic acid (C26:0) and the ratio of C26:0 and tetracosanoic acid(C24:0) to hexaenoic acid (C22:0). We report the case with a brief review of literature.

Atypical Hemolytic Uremic Syndrome Associated with Streptococcus pneumoniae Infection / 소아과

Hemolytic uremic syndrome is the most common cause of acute renal failure in childhood. Atypical hemolytic uremic syndrome which is not usually associated with prodromal symptoms has a higher mortality rate and more tendency to progress to chronic renal failure. Children younger than two years of age are a more susceptible to pneumococcal infection and can develop more serious disease. We report a 23 month-old male who suffered from pneumococcal pneumonia and progressed to hemolytic uremic syndrome requiring peritoneal dialysis. He recovered completely from acute renal failure after peritoneal dialysis and intravenous use of vancomycin.