Acute colonic pseudoobstruction in a child with sickle cell disease treated with neostigmine.
Sickle cell disease is a disorder that produces significant morbidity and mortality. Vaso-occlusive pain crises are the most common presenting symptom associated with sickle cell patients. A rare, yet important to recognize, complication of sickle cell disease is acute colonic pseudoobstruction, also known as Ogilvie's syndrome. These patients may present with symptoms that are difficult to distinguish from other etiologies of abdominal pain, but a thorough diagnostic workup can provide important clues. Furthermore, there is no agreement on optimal treatment of pseudoobstruction. We report the first pediatric case of acute pseudoobstruction secondary to sickle cell disease that was treated successfully with neostigmine. Early recognition of this phenomenon is important as it alters patient management, can be treated medically, and may avoid unnecessary surgical intervention.
Khosla
Arjun
A
Division of Pediatric Surgery, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH 44106, USA. arjun.khosla@utoledo.edu
Ponsky
Todd A
TA
D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000628:therapy; D001803:Blood Transfusion; D002675:Child, Preschool; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003112:Colonic Pseudo-Obstruction / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal; D009388:Neostigmine / Q000627:therapeutic use*; D010275:Parasympathetic Nervous System / Q000503:physiopathology
D002800:Cholinesterase Inhibitors; D009388:Neostigmine