Omullo Felix Pius, Mutisya Nick, Kinas Elisha, Kitheghe Thomas, Hassan Zamzam, Muhonja Rynah
Department of Pediatrics and Child Health, Murang'a County Referral Hospital, Murang'a 10200, Kenya.
World J Clin Pediatr. 2025 Sep 9;14(3):106463. doi: 10.5409/wjcp.v14.i3.106463.
Organophosphate (OP) poisoning is common in sub-Saharan Africa. It is associated with high mortality and morbidity. Affected individuals often exhibit cholinergic symptoms and respiratory distress. Moreover, other complications, such as pancreatitis, arrhythmias, and hepatic dysfunction, have been reported. However, paralytic ileus is an exceedingly rare complication.
We report a case of a 5-year-old boy who presented with altered sensorium and abdominal distension following suspected OP exposure. Physical examination and imaging revealed features of intestinal obstruction and neurological deficits. He was managed with atropine, pralidoxime, and other supportive measures and had a successful recovery. Paralytic ileus is an atypical complication of acute OP poisoning. The resultant intestinal obstruction manifests as cholinergic overactivity, leading to bowel dysmotility. This case emphasizes the need for awareness and prompt management of such atypical presentations, especially in the pediatric population.
Timely recognition and multidisciplinary management of atypical presentations, such as paralytic ileus, are crucial in improving outcomes in pediatric OP poisoning.
有机磷中毒在撒哈拉以南非洲地区很常见。它与高死亡率和高发病率相关。受影响的个体常表现出胆碱能症状和呼吸窘迫。此外,还报告了其他并发症,如胰腺炎、心律失常和肝功能障碍。然而,麻痹性肠梗阻是一种极其罕见的并发症。
我们报告一例5岁男孩,在疑似接触有机磷后出现意识改变和腹胀。体格检查和影像学检查显示肠梗阻和神经功能缺损的特征。他接受了阿托品、氯解磷定及其他支持性措施治疗,最终成功康复。麻痹性肠梗阻是急性有机磷中毒的一种非典型并发症。由此导致的肠梗阻表现为胆碱能活性亢进,进而引起肠道运动障碍。该病例强调了对此类非典型表现提高认识并及时处理的必要性,尤其是在儿科人群中。
及时识别并对麻痹性肠梗阻等非典型表现进行多学科管理,对于改善儿童有机磷中毒的预后至关重要。