Oral Lactulose-Induced Intussusception: A Rare Complication of Juvenile Colonic Polyp.

IF 0.7 Q4 GASTROENTEROLOGY & HEPATOLOGY

Case Reports in Gastroenterology Pub Date : 2025-09-12 eCollection Date: 2025-01-01 DOI:10.1159/000547462

Haizhi Tan, Xiaobing Xiao, Taotao Zhang, Shuyan Li

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Abstract

Introduction: As an osmotic laxative, lactulose offers superior palatability and comparable bowel-cleansing efficacy to PEG, making it suitable for resource-limited settings, but its hypertonicity may potentially increase the risk of intussusception in susceptible individuals (such as children with intestinal polyps).

Case presentation: This first reported case describes a 2-year-old boy with intermittent hematochezia who developed acute descending colonic intussusception confirmed by CT within hours of receiving lactulose (20 mL) for bowel preparation. Laparoscopic reduction and subsequent colonoscopy identified a large pedunculated juvenile polyp (25 × 28 mm) as the pathological lead point, which was endoscopically resected. The temporal link between lactulose administration and symptom onset, combined with its known pharmacological effects, strongly suggests lactulose-induced hyperperistalsis precipitated intussusception by mechanically displacing the occult polyp.

Conclusion: This highlights a novel risk of osmotic laxatives in children with undiagnosed intestinal polyp.

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口服乳果糖致肠套叠：一种罕见的幼年结肠息肉并发症。

作为一种渗透性泻药，乳果糖具有比PEG更好的适口性和类似的肠道清洁功效，使其适用于资源有限的环境，但其高渗性可能会增加易感个体（如肠息肉患儿）肠套叠的风险。病例介绍：首次报道的病例描述了一名2岁男孩间歇性便血，他在接受乳果糖（20ml）肠准备后数小时内出现急性结肠降速肠套叠，CT证实。腹腔镜复位及结肠镜检查发现一个大的带梗幼年息肉（25 × 28 mm）为病理先导点，经内镜切除。乳果糖给药与症状发作之间的时间联系，结合其已知的药理作用，强烈提示乳果糖诱导的过度蠕动通过机械移位隐匿性息肉而诱发肠套叠。结论：这突出了渗透性泻药对未确诊肠息肉儿童的新风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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