[Lethargic form of acute intestinal intussusception in an infant].
BACKGROUND
Intussusception encephalopathy, a misleading form in which neurological symptoms are obvious, is classic but rarely described.


METHODS
A 21 month-old infant was admitted because he had suffered from fluctuating consciousness and apathy for a few hours. Vomiting occurred soon afterwards. Search for dehydration, meningitis, encephalitis, poisoning... was negative; the abdomen was tender leading to ultrasonography that showed a sausage-shaped tumor. The ileocolic intussusception was successfully reduced with a gas enema.


CONCLUSIONS
A striking degree of lethargy associated with vomiting may overshadow to a considerable extent the classical intestinal manifestations. A possible endogenous opioid poisoning by massive secretion of endorphins during pain's paroxysm is one of the hypotheses explaining this type of presentation.
d'Escrienne
M M
MM
Centre médical infantile, hôpital pour Enfants, Nice, France.
Velin
P
P
Filippigh
P
P
Steyaert
H
H
Valla
J S
JS
Perelman
S
S
Dupont
D
D
D000208:Acute Disease; D001927:Brain Diseases / Q000209:etiology*; D004723:Endorphins / Q000378:metabolism / Q000494:pharmacology; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D007223:Infant; D007443:Intussusception / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D012894:Sleep Stages
D004723:Endorphins
Forme léthargique d'invagination intestinale aiguë du nourrisson.