Abstract

PEREZ, Luís; NAVARRO, Dianora; AGUIAR, Carla  and  NUNEZ, Christian. Acute Pseudoobstruction of Colon Post Chemotherapy in Pediatrics. Case Report. Gen [online]. 2017, vol.71, n.1, pp.21-24. ISSN 2477-975X.

Introduction: pseudo - obstruction of the colon is characterized by marked dilatation in the absence of mechanical obstruction, being uncommon in children. It indicates an imbalance of the autonomic nervous system triggered by drugs, intestinal ischemia, systemic or local inflammation of th e peritoneum among others. Clinical case : male schoolboy of 8 years old, with abdominal pain of strong intensity, colic type, associated with fever, and fifth day without evacuation. Background of Testicular Embryonal Rhabdomyosarcoma, recent chemotherapy with Vincristine, Ifosfamide, Dacinomycin and Adriamycin. Physical examination: painful facies, oral mucosa ulcers and cheilitis. Tachycardia 120xmin. Abdomen: tympanic, voluntary defense in the right iliac fossa and hypogastrium, non - mobile mass in the ar ea, scarce hydroaéreo noises. Erythema and exudate. Right scrotal pouch empty. Neurological without targeting. Laboratory: anemia, leukocytosis with neutrophilia, negative cultures (blood - urine - feces). Abdominal x - ray: increased neural content from gastric chamber to colon, fecal pattern increased in right colon and distention. Tumor tomography with oral contrast: No progression of contrast from terminal ileum to cecum after 9 hours, distension of the colon with air to right predominance with increased feca l content, fluid in the rectum. Clinical diagnosis: Acute colonic pseudobstruction. Oral detoxification is indicated with Colayte ® and Trimebutina. Pain therapy: dipyrone, tramadol and gabapentin. Good evolution at 72 hours. Discussion: Colon dilatation i n children with constipation after chemotherapy is highly suggestive of pseudobstruction and imaging studies are important for the diagnosis in pediatric patients.

Keywords : acute colonic pseudobstruction; constipation; vincristine; trimebutine; oral deimpactation.

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