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Pediatric emergency care · Mar 1987
Case ReportsEarly coma in intussusception: endogenous opioid induced?
- M Tenenbein and N E Wiseman.
- Pediatr Emerg Care. 1987 Mar 1; 3 (1): 22-3.
AbstractA decreased level of consciousness with little abdominal pain or gastrointestinal symptoms is an uncommon, but well described, presentation of infantile intussusception. Its etiology is unclear. We describe a 10-month-old male who presented with coma and miosis, reversible with bolus injections of naloxone on three separate occasions. No opiates were involved and an intussusception was subsequently found. We speculate that the coma and miosis were induced by an endogenous opioid which could also mask the abdominal pain, thus explaining this presentation of intussusception. If so, miosis would be a valuable clue for diagnosing such children.
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