Pediatr Gastroenterol Hepatol Nutr.  2017 Jun;20(2):130-133. 10.5223/pghn.2017.20.2.130.

Ileal Perforation with Norovirus Gastroenteritis in a 3-Month-Old Infant

• Wi SW
• Lee SJ
• Kang EK
• Cho SM

• KMID: 2384827
• DOI: http://doi.org/10.5223/pghn.2017.20.2.130

Abstract

Noroviruses have been recognized as the leading cause of epidemic and sporadic gastroenteritis since the advent of molecular diagnostic technique. They have been documented in 5-31% of pediatric patients hospitalized with gastroenteritis. Although norovirus gastroenteritis is typically mild and self-limited, it causes severe, but sometimes fatal, conditions in the vulnerable population such as immunocompromised patients, young children, and the elderly. Bowel perforation due to norovirus infection is rare. We report a case of small bowel perforation with norovirus gastroenteritis in the infant with Down syndrome during the hospitalization with pneumonia. Severe dehydration may cause bowel ischemia and could have triggered bowel perforation in this case. Physicians should be alert to the potential surgical complications followed by severe acute diarrhea, especially in high risk groups.

Keyword

Norovirus; Gastroenteritis; Child

MeSH Terms

Aged
Child
Dehydration
Diarrhea
Down Syndrome
Gastroenteritis*
Hospitalization
Humans
Immunocompromised Host
Infant*
Ischemia
Molecular Diagnostic Techniques
Norovirus*
Pneumonia
Vulnerable Populations

Figure

• 

  Fig. 1 (A) A plain radiograph of the abdomen demonstrated free air (black arrows) on the upper abdomen. (B) There was free air (white arrow) between the abdominal wall and the bowel loops on the cross-table abdominal radiogram.

• 

  Fig. 2 The gross specimen of the resected ileum. The mucosal surface shows two segmental necrotic areas with a perforation (arrow).

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