Prestenotic enteritis and enterocolitis in children: Description of a syndrome and review of five cases.

A clinical syndrome of prestenotic enteritis and enterocolitis consisting of abdominal distention and pain, intermittent diarrhea and constipation, failure to thrive, fever and in some patients, extreme prostration and death is described. The pathogenesis of this enteritis and enterocolitis apparently is related to partial mechanical obstruction of the bowel with proximal dilatation, stagnation, and capillary stasis. Acute relief from the enteritis and enterocolitis may be obtained by stomal dilatation and colonic irrigation; however, all patients in our series required surgical intervention. because mortality in this disease is significant and the results with early surgical intervention are favorable, surgical intervention is encouraged at the first sign of prestenotic enteritis or enterocolitis in children. Surgical correction of the distal stenosis produced a growth spurt in the two successfully treated patients without other growth-limiting disease.