Pediatr Gastroenterol Hepatol Nutr.  2013 Sep;16(3):162-170. 10.5223/pghn.2013.16.3.162.

Clinical Features and Role of Viral Isolates from Stool Samples of Intussuception in Children

• Lee YW
• Yang SI
• Kim JM
• Kim JY

• KMID: 2051329
• DOI: http://doi.org/10.5223/pghn.2013.16.3.162

Abstract

PURPOSE
To detect major acute gastroenteritis virus (rotavirus, norovirus, astrovirus, and enteric adenovirus) and non-enteric type of adenovirus (AdV) in the stools of intussusception patients and to investigate the clinical role of detected viruses.
METHODS
From March 2012 to February 2013, major acute gastroenteritis virus and non-enteric type of AdV were isolated from stool samples that collected from 44 patients treated for intussusception in Chungnam National University Hospital. Patients were divided according to age and isolated virus.
RESULTS
Virus was detected in 28 (63%) stool specimens. The virus detection rate was significantly lower in patients aged under 12 months (p = 0.04). Twenty-two patients (78.6%) had non-enteric adenovirus, 4 (14.3%) had norovirus, 1 (3.6%) had sapovirus, and 1 (3.6%) had astrovirus. AdV subgroup C (AdV 1, 2, 5, and 6) comprised the majority with 20 cases (90.9%). A monthly increment-and-decrement pattern of intussusception was similar to that of viral detection in the stool samples. Enema reductions were successful in 39 patients and surgical manual reductions were performed in 5 patients. Virus was detected in 24 patients (61.5%) of enema reduction group and 4 patients (80.0%) of surgical manual reduction group. All of the detected viruses were non-enteric adenovirus subgroup C (AdV 1, 5, and 6) in surgical reduction patients.
CONCLUSIONS
The virus detection rate was high in the stools of intussusception patients. The pattern of seasonal intussusception occurrence rate was parallel with seasonal these viral detection rate in the stool samples. These findings suggest that viral infection plays an important role in the development of intussusception and further research is warranted.

Keyword

Intussusception; Non-enteric type of adenovirus; Norovirus

MeSH Terms

Adenoviridae
Aged
Child
Enema
Gastroenteritis
Humans
Intussusception
Norovirus
Sapovirus
Seasons
Viruses

Figure

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  Fig. 1 The number of patients with intussusception and viral isolates by age. The number of cases show non-enteric adenovirus isolates (n=22), AGE virus isolates (n=6), and no virus isolates (n=16). AGE virus: acute gastroenteritis virus including noro, spo, astro, enteric adeno, and rota virus. p=0.041.

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  Fig. 2 Viruses detected from stool specimens of patients with intussusception.

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  Fig. 3 Monthly distribution of viruses isolated and incidence of intussusception. AGE virus isolated included 1 astrovirus and 4 norovirus. Astrovirus was isolated in August. Calicivirus (norovirus, sapovirus) and enteric adenovirus were isolated from December to February. AGE virus: acute gastroenteritis virus including noro, spo, astro, enteric adeno, and rota virus.

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