A Case of Chronic Intestinal Pseudo-obstruction Syndrome

Park, Hye Won; Chang, Chul Ho; Park, Bum Soo; Seo, Jeong Kee; Park, Sung Hye; Chi, Je Geun; Yeon, Kyung Mo; Park, Kui Won

Case Report

Journal of the Korean Pediatric Society 1992;35(10):1427-1434.
Published online October 15, 1992.

A Case of Chronic Intestinal Pseudo-obstruction Syndrome

Hye Won Park¹, Chul Ho Chang¹, Bum Soo Park¹, Jeong Kee Seo¹, Sung Hye Park², Je Geun Chi², Kyung Mo Yeon³, Kui Won Park⁴

¹Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
²Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
³Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
⁴Department of Pediatric Surgery, Seoul National University College of Medicine, Seoul, Korea

만성 가성 장폐색 증후군 1례

박혜원^¹^, 장철호^¹^, 박범수^¹^, 서정기^¹^, 박성혜^²^, 지제근^²^, 연경모^³^, 박귀원^⁴

^¹서울대학교 의과대학 소아과학교실
^²서울대학교 의과대학 병리학교실
^³서울대학교 의과대학 진단방사선과학교실
^⁴서울대학교 의과대학 소아외과학교실

Abstract

Chronic intestinal pseudo-obstruction is a clinical condition in which impaired intestinal propulsion causes recurrent symptoms of bowel obstruction in the absence of mechanical occlusion. In this paper a female neonate was presented with vomiting and abdominal distension in the first few days of life but passed normal meconium. Barium enema showed a microcolon and an abnormaly sited cecum. Malrotation of bowel was noted at laparotomy. Resection and anastomosis of involved ileum and division of Ladd's band were performed. The surgical biopsy specimen showed no abnormalities with ganglion cells on routine stains. Symptoms and signs of intestinal obstruction recurred on the 17th postoperative day. Exploratory laparotomy and ileostomy were performed on 24th and 33rd hospital day respectively. She had been on total parenteral nutrition and domperidone in an attempto to stimulate peristalsis because of persistent vomiting and abdominal distension with enteral feedings. The radiologic studies revealed almost absent peristalsis of the bowel with no mechanical obstruction and the barium retained for more than 10 days on the infantogram. Her general condition deteriorated with hepatic dysfunction and sepsis as complications of parenteral nutrition during the total 128 hospital days.

Key Words: Chronic intestinal pseudo-obstruction