title: Toxic epidermal necrolysis complicated by small bowel intussusception: a case report.
abstract: Intestinal involvement in toxic epidermal necrolysis (TEN) has been identified only rarely. We report a case of TEN complicated by small bowel intussusception. The patient was a previously healthy 8-year-old boy who presented with TEN and extensive lesions, including up to 40% of the body surface area as well as conjunctival, oropharyngeal, respiratory, and genital mucosa. Rapidly after the onset of a constant rate of enteral feeding, he developed bilious vomiting, diarrhea, and significant abdominal distension. Abdominal sonography showed a small bowel intussusception. At abdominal exploration, an ileoileal intussusception was observed with a viable but inflamed bowel wall. Manual reduction was performed. During the postoperative clinical course, the patient was managed with total parenteral nutrition and local care of the skin and mucous membranes. Enteral feeding was introduced on the sixth postoperative day, and the child left the hospital 15 days after his admission. The association of TEN and small bowel intussusception has not been previously reported in the literature.
authors.affiliation: Paediatric Intensive Care Unit, Children's Hospital of Tunis, Tunis, Tunisia. asma.bouziri@yahoo.fr
authors.forename: Asma
authors.initials: A
authors.lastname: Bouziri
authors.forename: Ammar
authors.initials: A
authors.lastname: Khaldi
authors.forename: Asma
authors.initials: A
authors.lastname: Hamdi
authors.forename: Aida
authors.initials: A
authors.lastname: Borgi
authors.forename: Sofiene
authors.initials: S
authors.lastname: Ghorbel
authors.forename: Monia
authors.initials: M
authors.lastname: Kharfi
authors.forename: Sarra Bel
authors.initials: SB
authors.lastname: Hadj
authors.forename: Khaled
authors.initials: K
authors.lastname: Menif
authors.forename: Nejla
authors.initials: N
authors.lastname: Ben Jaballah
mesh_terms: D002648:Child; D006801:Humans; D007077:Ileal Diseases / Q000150:complications* / Q000601:surgery; D007082:Ileum / Q000473:pathology / Q000601:surgery; D007443:Intussusception / Q000150:complications* / Q000601:surgery; D008297:Male; D010289:Parenteral Nutrition, Total; D013262:Stevens-Johnson Syndrome / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome