Simultaneous intussusception associated with adenovirus infection in monozygotic twins

Abstract

Rationale: Intussusception, a common cause of intestinal obstruction in children, typically requires medical reduction. Here, we describe the case of a pair of twins who had simultaneous intussusception and were positive for fecal adenovirus—strongly indicating that adenovirus infection may be a main cause of the intussusception. Patient concerns: Two 1-year-old twin girls were brought to Cathay General Hospital one after another on the same day. Both presented with intermittent abdominal pain, abdominal distension, diarrhea, and loss of appetite. Diagnoses: Their laboratory data were adenovirus positivity in rectal swab culture. Intussusception was diagnosed through a lower gastrointestinal series. Interventions: The twins were treated with reduction for intussusception. Outcomes: Both patients recovered well, without recurrence. Lessons: Most cases of intussusception are idiopathic. However, some potential risk factors—as strongly suggested by the current cases—are genetic factors and adenovirus infection.

Nonenteric Adenoviruses Associated with Gastroenteritis in Hospitalized Children

“…Three patients had different clinical conditions, such as intussusception, biliary atresia, and Kawasaki disease, which have been associated with adenovirus ( 30 – 35 ).…”

Proof of the association between adenovirus infection and appendicitis in children through pathological evidence

“…Another study showed simultaneous intussusception and adenovirus infection in monozygotic twins (2).…”

“…While adenoviruses are a rarely reported cause of acute appendicitis in children, they are a wellrecognized cause of intussusception in infants and young children (1)(2)(3)(4). Human adenoviruses are classi ed into seven species (A-G) and 52 recognized serotypes.…”