Unusual Presentation of Celiac Disease in a Toddler from a Pediatric Surgery Unit

Celiac disease is an intestinal autoimmune disease induced by the ingestion of gluten proteins (wheat, rye, barley) in genetically susceptible individuals. Celiac disease can present with gastrointestinal or extraintestinal manifestations (malabsorbtion, diarrhea, constipation, liver, skin or bones disorders). We present the case of a 14-months-old girl admitted for altered general condition and symptoms of intestinal occlusion (severe abdominal pain, absence of feces, abdominal distension), with associated severe malnutrition. History revealed chronic diarrhea and a lactose intolerance diagnosed 3 months prior to admission. The biochemical and imaging investigations excluded any acute surgical pathology. The serological tests showed high values of anti-tissue transglutaminase antibodies. The intestinal biopsy confirmed celiac disease. In children with suspicion of intestinal obstruction associated with a history of diarrhea or constipation and failure to thrive, testing for celiac disease should be considered.