Paediatric intussusception caused by acquired immunodeficiency syndrome-associated Kaposi sarcoma.
OBJECTIVE
To document the clinicopathological features of paediatric intussusception caused by acquired immunodeficiency syndrome (AIDS)-associated Kaposi sarcoma (KS).


METHODS
Clinicopathological features of six patients with AIDS-KS-associated intussusception were obtained retrospectively from departmental and hospital records.


RESULTS
Six debilitated male children, without cutaneous KS, were presented with abdominal pain and vomiting for >1 week. Intussusception was the sentinel of HIV infection in five patients. One patient had been on HAART for 13 months. Three patients each had ileal and ileocolic intussusceptions; two had recurrent intussusception. Bowel resection was performed because of failed reduction, infarction and polypoid lead points in all patients, in addition to perforation and peritonitis in three. Five patients died, the immediate cause being massive hematochezia from anorectal KS and/or septic shock. One patient, who received post-surgical chemotherapy and HAART, is currently in remission. Pathologic examination confirmed intussusception due to KS.


CONCLUSIONS
AIDS-KS-associated intussusception occurred without cutaneous KS. Resection of the infarcted segment may relieve the presenting obstruction, but recurrent intussusception may occur because every elevated KS is a potential lead point. AIDS-KS-I is rare but fatal in children, unless timely surgical intervention, optimal histopathological diagnosis, and appropriate medical management, including HAART and chemotherapy, are facilitated.
Ramdial
Pratistadevi K
PK
Department of Anatomical Pathology, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu Natal, South Africa.
Sing
Yetish
Y
Hadley
G P
GP
Chotey
Nivesh A
NA
Mahlakwane
Mabitsela S
MS
Singh
Bhugwan
B
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D023241:Antiretroviral Therapy, Highly Active; D002675:Child, Preschool; D006801:Humans; D007443:Intussusception / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D012514:Sarcoma, Kaposi / Q000150:complications* / Q000401:mortality