Abdominal ultrasonographic findings, including small bowel
intussusception in patients with acute food protein-induced
enterocolitis syndrome
Abstract
Background Food protein-induced enterocolitis syndrome (FPIES)
is a non-immunoglobulin E (IgE)-mediated food allergy that affects
infants. It is characterized by massive and repetitive vomiting,
lethargy, pallor, and watery diarrhea. Although FPIES can mimic acute
gastrointestinal diseases, for which ultrasonography is useful, few
studies on ultrasonographic findings in non-IgE-mediated food allergic
disorders are available. We investigated the ultrasonographic features
of patients with FPIES. Methods Patients who underwent an oral
food challenge (OFC) test or were diagnosed with acute FPIES were
enrolled. We divided the patients into the FPIES and non-FPIES groups.
Ultrasonography was performed before and 6h after the OFC test. Patients
in the FPIES group underwent ultrasonography 24 h after the OFC tests.
We evaluated intestinal findings, including peristaltic movement, fluid
accumulation, and wall thickness of the gastrointestinal tract.
Results Fourteen patients in the FPIES group and 11 in the
non-FPIES group were enrolled. Ultrasonography performed 6h after the
OFC test showed that the number of patients with small intestinal fluid
accumulation and hyperperistalsis was significantly higher in the FPIES
group than in the non-FPIES group. In the FPIES group, jejunal wall
thickness significantly increased 6h after the OFC test. Small bowel
intussusception occurred in three patients with FPIES.
Conclusions Small-intestinal wall thickening, fluid
accumulation, and abnormal peristalsis on ultrasonography suggest its
utility in diagnosing FPIES. In cases of small intestinal
intussusception, FPIES should be considered in the differential
diagnosis.