Chronic intestinal pseudoobstruction: report of four pediatric patients.

Chronic intestinal pseudoobstruction is a rare disorder of intestinal motility, characterized by recurrence of continuous symptoms and signs of intestinal obstruction in the absence of true mechanical obstruction. Congenital or systemic disorders are the causes of chronic intestinal pseudoobstruction. The term idiopathic is applied when there is no congenital or secondary cause. Early diagnosis of intestinal pseudoobstruction is important to avoid repeated laparotomies. Treatment of chronic intestinal pseudoobstruction is usually supportive. Besides the supportive therapy, prokinetic agents such as erythromycin and octreotide are used in the therapy. In this article, four pediatric patients diagnosed as chronic intestinal pseudoobstruction are discussed with their clinical findings and laboratory abnormalities. The etiology of chronic intestinal pseudoobstruction was visceral myopathy in one patient. Two had idiopathic chronic intestinal pseudoobstruction and the other patient developed chronic intestinal pseudoobstruction after cardiac surgery. Erythromycin was administered to all four patients, one of whom did not respond to this therapy. Octreotide was effective in this case.