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Acute colonic pseudoobstruction in a child with sickle cell disease treated with neostigmine

Arjun Khosla1, Todd A Ponsky

  • 1Division of Pediatric Surgery, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH 44106, USA. arjun.khosla@utoledo.edu

Journal of Pediatric Surgery
|December 2, 2008
PubMed

Insights

Sickle cell disease patients can develop acute colonic pseudoobstruction, a rare complication. This case report details successful treatment with neostigmine in a pediatric patient, avoiding surgery.

Area of Science:

  • Gastroenterology
  • Hematology
  • Pediatric Medicine

Background:

  • Sickle cell disease (SCD) is a genetic blood disorder causing significant morbidity and mortality.
  • Vaso-occlusive pain crises are the hallmark symptom of SCD.
  • Acute colonic pseudoobstruction (Ogilvie's syndrome) is a rare but serious complication in SCD patients.

Observation:

  • Patients with SCD presenting with abdominal pain may have symptoms mimicking other conditions.
  • Distinguishing pseudoobstruction from other causes of abdominal pain requires careful diagnostic evaluation.
  • There is no established consensus on the optimal management of pseudoobstruction in SCD.

Findings:

  • This report details the first pediatric case of acute colonic pseudoobstruction secondary to sickle cell disease.
  • The patient was successfully treated with neostigmine, a medical intervention.
  • Early diagnosis and medical management with neostigmine can avoid surgical intervention.

Implications:

  • Recognizing acute colonic pseudoobstruction in SCD is crucial for appropriate patient management.
  • Neostigmine offers a viable medical treatment option for this complication.
  • This approach can prevent unnecessary surgical procedures in pediatric SCD patients.

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