Intussusception as a rare cause of abdominal pain in a child with idiopathic nephrotic syndrome: a case report and review of literature
4 affiliations
- 1Department of Paediatrics, Faculty of Medicine, University of Kelaniya
- 2University Paediatrics Unit, Colombo North Teaching Hospital
- 3Paediatric Unit, Base Hospital Wathupitiwala
- 4Paediatric Surgical Unit, Colombo North Teaching Hospital
Abstract
Background Intussusception is a rare cause of abdominal pain in children with nephrotic syndrome with only a few reported cases. The best management pathway has still not yet been determined, with two case reports describing the response to intravenous albumin infusion with loop diuretics, and others reporting the need for pneumatic, hydrostatic, or surgical reduction. This case report describes a child with nephrotic relapse with two simultaneous intussusceptions: an ileo-ileal intussusception that responded to intravenous albumin with Furosemide, and a colo-colic intussusception that needed hydrostatic reduction. Case presentation A seven-year-old boy with idiopathic nephrotic syndrome presented with his first relapse. On admission he had mild periorbital and ankle oedema and was started on prednisolone induction therapy. On day five of induction, the patient developed abdominal pain. He had developed significant weight gain and worsening oedema. The periumbilical pain escalated within hours to an excruciating continuous central abdominal pain with a poor response to analgesics. Even though he developed a fever spike, he remained well perfused with good urine output and no clinical evidence of peritonitis. Inflammatory markers including C-reactive protein were negative. The serum albumin level was markedly low, and the serum amylase level was normal. An intravenous infusion of 20% albumin 1g/kg over 4 hours with Furosemide had negligible effect on abdominal pain. Abdominal ultrasound revealed one ileo-ileal and another colo-colic intussusception. Ultrasound was repeated 5 hours after the albumin infusion which was able to visualize only the colo-colic intussusception, which was then hydrostatically reduced. The ileo-ileal intussusception had already been reduced following the albumin infusion. The boy’s abdominal pain improved soon after, and he made a complete recovery achieving nephrotic remission on day fifteen of induction. Conclusion A broad differential diagnosis of abdominal pain in children with nephrotic syndrome is vital. If pain persists despite exclusion and treatment of common causes, an ultrasound would be useful for identifying intussusception. Compared with colo-colic intussusception, ileo-ileal intussusception in nephrotic syndrome patients may be more amenable to treatment with intravenous albumin and loop diuretics.
Related
- Vascular Remodelling in Idiopathic Nephrotic Syndrome with Administration of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers
- Decoding Immune Dysregulation in Childhood Idiopathic Nephrotic Syndrome: Insights From Lymphocyte Subsets and Urinary Cytokine Analysis
- Postoperative Idiopathic Intussusception in an Adult: A Case Report
- Diagnostic Accuracy of Abdominal Ultrasound in Pediatric Patients with Signs and Symptoms of Intussusception
- Nintedanib-induced Glomerular Microangiopathy after Long-term Nintedanib Administration Presenting with Nephrotic Syndrome
BibTeX
@article{athapathu2026intussusception,
title = {{Intussusception as a rare cause of abdominal pain in a child with idiopathic nephrotic syndrome: a case report and review of literature}},
author = {A. S. Athapathu and A. K. Fathima Nisra and K. E. G. P. Padmasiri and R. P. A. S. Rajapakshe and N. D. W. Arachchige},
journal = {BMC Pediatrics},
year = {2026},
month = jul,
doi = {10.1186/s12887-026-07417-x},
url = {https://doi.org/10.1186/s12887-026-07417-x},
note = {CC BY},
}
RIS
TY - JOUR
TI - Intussusception as a rare cause of abdominal pain in a child with idiopathic nephrotic syndrome: a case report and review of literature
AU - A. S. Athapathu
AU - A. K. Fathima Nisra
AU - K. E. G. P. Padmasiri
AU - R. P. A. S. Rajapakshe
AU - N. D. W. Arachchige
PY - 2026
DA - 2026/07/01
JO - BMC Pediatrics
DO - 10.1186/s12887-026-07417-x
UR - https://doi.org/10.1186/s12887-026-07417-x
AB - Background Intussusception is a rare cause of abdominal pain in children with nephrotic syndrome with only a few reported cases. The best management pathway has still not yet been determined, with two case reports describing the response to intravenous albumin infusion with loop diuretics, and others reporting the need for pneumatic, hydrostatic, or surgical reduction. This case report describes a child with nephrotic relapse with two simultaneous intussusceptions: an ileo-ileal intussusception that responded to intravenous albumin with Furosemide, and a colo-colic intussusception that needed hydrostatic reduction. Case presentation A seven-year-old boy with idiopathic nephrotic syndrome presented with his first relapse. On admission he had mild periorbital and ankle oedema and was started on prednisolone induction therapy. On day five of induction, the patient developed abdominal pain. He had developed significant weight gain and worsening oedema. The periumbilical pain escalated within hours to an excruciating continuous central abdominal pain with a poor response to analgesics. Even though he developed a fever spike, he remained well perfused with good urine output and no clinical evidence of peritonitis. Inflammatory markers including C-reactive protein were negative. The serum albumin level was markedly low, and the serum amylase level was normal. An intravenous infusion of 20% albumin 1g/kg over 4 hours with Furosemide had negligible effect on abdominal pain. Abdominal ultrasound revealed one ileo-ileal and another colo-colic intussusception. Ultrasound was repeated 5 hours after the albumin infusion which was able to visualize only the colo-colic intussusception, which was then hydrostatically reduced. The ileo-ileal intussusception had already been reduced following the albumin infusion. The boy’s abdominal pain improved soon after, and he made a complete recovery achieving nephrotic remission on day fifteen of induction. Conclusion A broad differential diagnosis of abdominal pain in children with nephrotic syndrome is vital. If pain persists despite exclusion and treatment of common causes, an ultrasound would be useful for identifying intussusception. Compared with colo-colic intussusception, ileo-ileal intussusception in nephrotic syndrome patients may be more amenable to treatment with intravenous albumin and loop diuretics.
SN - 1471-2431
ER -