title: [Changes in the consciousness state as a symptom of intestinal invagination onset].
abstract: Intussusception is the most frequent cause of intestinal occlusion in children aged 3-5 years. Diagnosis is easy to perform in cases with typical clinical presentation. However diagnosis may be difficult in rare cases with atypical symptoms characterized by SNC involvement, that could delay a convenient treatment. We report 4 cases of intussusception presenting initially with consciousness abnormalities, hypotonia and vomiting. In these cases differential diagnosis with other conditions associated with comatose states has to be performed. Some hypothesis may be considered to explain these clinical pictures: 1. increased endorphins excretion during abdominal pain; 2. neurotoxins of bacterial origin released and absorbed by altered bowel; 3. intestinal hormones abnormally produced during the disease. As recommended by Rachmel, the condition should be suspected in all children presenting with the association of vomiting and lethargy and a radiological or tomographic study of abdomen should be performed also in cases without intussusception typical symptoms.
authors.affiliation: Divisione di Pediatria, Ospedale S. Carlo Borromeo, Milano, Italia.
authors.forename: R
authors.initials: R
authors.lastname: Sangermani
authors.forename: M
authors.initials: M
authors.lastname: Gibelli
authors.forename: P
authors.initials: P
authors.lastname: Vaglia
authors.forename: R
authors.initials: R
authors.lastname: Vaccari
mesh_terms: D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000150:complications*; D007223:Infant; D007443:Intussusception / Q000150:complications*; D008297:Male; D014474:Unconsciousness / Q000209:etiology*
vernacular_title: Alterazione dello stato di coscienza come sintomo di esordio di invaginazione intestinale.