Gastrointestinal complications of post-diarrheal hemolytic uremic syndrome

Eur J Pediatr Surg. 2007 Oct;17(5):328-34. doi: 10.1055/s-2007-965013.


Purpose: Whereas gastrointestinal symptoms such as vomiting, diarrhea and abdominal pain are common in children suffering from the so-called post-diarrheal form (D+) of hemolytic uremic syndrome (HUS), more serious gastrointestinal complications are rare. We tried to define factors predictive of the severity of gastrointestinal complications post D+ HUS.

Methods: We reviewed the files of all children admitted to our hospital for D+ HUS between 1988 and 2000. We retained those cases with gastrointestinal complications and analyzed the consequences of these complications on the evolution of the children's conditions.

Results: Sixty-five children with D+ HUS were admitted to our hospital during this period. Sixteen children developed gastrointestinal complications involving one or more digestive organs: necrosis of the colon or ileum, hemorrhagic colitis, pancreatitis, transient diabetes, hepatic cytolysis and cholestasis, peritonitis and prolapse of the rectum. One child died.

Conclusion: Gastrointestinal complications of D+ HUS are rare, but they can be lethal, and early surgery may sometimes prove necessary. However, we were not able to demonstrate a correlation between the severity of the gastrointestinal manifestations and the clinical or biological signs accompanying D+ HUS.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Diarrhea / complications*
  • Female
  • Follow-Up Studies
  • Gastrointestinal Diseases / diagnosis
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / etiology*
  • Hemolytic-Uremic Syndrome / complications*
  • Humans
  • Incidence
  • Infant
  • Male
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index