Öz
Diyabetik ketoasidoz (DKA) genellikle özellikle çocuklarda Tip 1 diabetes mellitusun ilk belirtisi olarak ortaya çıkar. Karın ağrısı, kusma ve bulantı gibi semptomlar genellikle DKA ile ilişkilendirilirken, klinisyenler invajinasyon gibi nadir durumları da göz önünde bulundurmalıdır. Ergenlik dönemi için nadir bir klinik tanı olan invajinasyon, öncü noktalar ve metabolik değişikliklerin bir sonucu olabilir. Bu olgu sunumu, DKA’lı bir ergende invajinasyon oluşumunu vurgulamakta ve bu iki durumu birbirine bağlayan potansiyel mekanizmaları incelemektedir.
Anahtar Kelimeler: Diyabetik ketoasioz, ergen, invajinasyon
Kaynakça
Mayer-Davis EJ, Kahkoska AR, Jefferies C, Dabelea D, Balde N, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes. 2018;19(Suppl 27):7-19.
Quinn M, Fleischman A, Rosner B, Nigrin DJ, Wolfsdorf JI. Characteristics at diagnosis of type 1 diabetes in children younger than 6 years. J Pediatr. 2006;148:366-71.
Elizabeth Fialkowski, Warner BW. Intestinal Obstructions. In: Kleinman RE, Goulet O, Mieli-Vergani G, Sanderson IR, Sherman PM, Shneider BL, editors. Walker’s pediatric gastrointestinal disease : pathophysiology, diagnosis, management. Sixth edition ed. Raleigh, N.C.: People’s Medical Publishing House-USA; 2018.
Rashid S, Rajan D, Jacob R, Dahl K, Prasad A, et al. Colonic metastases from pleomorphic carcinoma of the lung presenting as an ileocecal intussusception. ISRN Gastroenterol. 2011;2011:137139.
Russo A, Fraser R, Horowitz M. The effect of acute hyperglycaemia on small intestinal motility in normal subjects. Diabetologia. 1996;39:984-9.
Björnsson ES, Urbanavicius V, Eliasson B, Attvall S, Smith U, Abrahamsson H. Effects of hyperglycemia on interdigestive gastrointestinal motility in humans. Scand J Gastroenterol. 1994;29:1096-104.
Writing Group for the SfDiYSG, Dabelea D, Bell RA, D’Agostino RB, Jr., Imperatore G, Johansen JM, et al. Incidence of diabetes in youth in the United States. JAMA. 2007;297:2716-24.
Klingensmith GJ, Tamborlane WV, Wood J, Haller MJ, Silverstein J, et al. Diabetic ketoacidosis at diabetes onset: still an all too common threat in youth. J Pediatr. 2013;162:330-4.e1.
Soykan I, Sivri B, Sarosiek I, Kiernan B, McCallum RW. Demography, clinical characteristics, psychological and abuse profiles, treatment, and long-term follow-up of patients with gastroparesis. Dig Dis Sci. 1998;43:2398-404.
Kong MF, Horowitz M, Jones KL, Wishart JM, Harding PE. Natural history of diabetic gastroparesis. Diabetes Care. 1999;22:503-7.
Koh JS, Hahm JR, Jung JH, Jung TS, Rhyu SS, et al. Intussusception in a young female with Vibrio gastroenteritis and diabetic ketoacidosis. Intern Med. 2007;46:171-3.
McFarlane SI, Byrne K, Shin J, Williams R. Intussusception in an adult patient with severe hyperglycaemia--a case report. Diabet Med. 2002;19:611-4.
Lahousen T, Lipp RW, Schnedl WJ. Can hyperglycaemia cause jejuno-jejunal intussusception? Diabet Med. 2003;20:335-6; author reply 6.
Raghavan P, Salon J, Rajan D. Multiple intestinal intussusceptions as a complication of severe hyperglycemia in a patient with diabetic ketoacidosis. Case Rep Endocrinol. 2012;2012:526041.
Byrne MM, Pluntke K, Wank U, Schirra J, Arnold R, et al. Inhibitory effects of hyperglycaemia on fed jejunal motility: potential role of hyperinsulinaemia. Eur J Clin Invest. 1998;28:72-8.
Fraser R, Horowitz M, Dent J. Hyperglycaemia stimulates pyloric motility in normal subjects. Gut. 1991;32:475-8.
Fraser RJ, Horowitz M, Maddox AF, Harding PE, Chatterton BE, et al. Hyperglycaemia slows gastric emptying in type 1 (insulin-dependent) diabetes mellitus. Diabetologia. 1990;33:675-80.
Koch KL. Diabetic gastropathy: gastric neuromuscular dysfunction in diabetes mellitus: a review of symptoms, pathophysiology, and treatment. Dig Dis Sci. 1999;44:1061-75.
Marsicovetere P, Ivatury SJ, White B, Holubar SD. Intestinal Intussusception: Etiology, Diagnosis, and Treatment. Clin Colon Rectal Surg. 2017;30:30-9.
Munden MM, Bruzzi JF, Coley BD, Munden RF. Sonography of pediatric small-bowel intussusception: differentiating surgical from nonsurgical cases. AJR Am J Roentgenol. 2007;188:275-9.
Gayer G, Zissin R, Apter S, Papa M, Hertz M. Pictorial review: adult intussusception--a CT diagnosis. Br J Radiol. 2002;75:185-90.
Kisakol G, Kayacetin E, Sari O, Kaya A. Gastric emptying in subclinical hyperthyroidism. Neuro Endocrinol Lett. 2003;24:255-8.
Akyürek N, Atabek ME, Eklioglu BS. Intestinal invagination in diabetic ketoacidosis: case report. J Pediatr Endocrinol Metab. 2015;28:73-4.
Shah N, Khadilkar V, Khadilkar A, Jahagirdar R. Intussusception as a rare clinical presentation of a child with type 1 diabetes and diabetic ketoacidosis. BMJ Case Rep. 2020;13.
