All issues > Volume 35(10); 1992

Case Report

J Korean Pediatr Soc. 1992;35(10):1427-1434. Published online October 15, 1992.

A Case of Chronic Intestinal Pseudo-obstruction Syndrome

Hye Won HW Park¹, Chul Ho CH Chang¹, Bum Soo BS Park¹, Jeong Kee JK Seo¹, Sung Hye SH Park², Je Geun JG Chi², Kyung Mo KM Yeon³, Kui Won KW 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

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.

Keywords :Chronic intestinal pseudo-obstruction