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A Case of Chronic Intestinal Pseudo-obstruction Syndrome

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
박혜원1, 장철호1, 박범수1, 서정기1, 박성혜2, 지제근2, 연경모3, 박귀원4
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


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