Ischemic colitis in an infant with constipation treated with stimulant laxative

Area of Science:

• Gastroenterology
• Pediatric Medicine
• Vascular Medicine

Background:

• Ischemic colitis (IC) is a common form of intestinal ischemia, typically affecting the elderly due to comorbidities.
• Risk factors for IC include cerebrovascular disease, hypertension, diabetes, abdominal surgery, IBS, and constipation.
• Infantile IC is rare, with limited documented cases, especially those linked to constipation.

Observation:

• A 1-year-old girl with a history of constipation and stimulant laxative use presented with hypovolemic shock.
• Imaging revealed colonic distension with stool, followed by persistent bloody diarrhea.
• Colonoscopy showed mucosal sloughing, pseudomembranes, and stenosis.

Findings:

• The patient was diagnosed with ischemic colitis.
• Treatment included parenteral nutrition and an elemental diet.
• Resolution of symptoms and stenosis was confirmed by follow-up procedures.

Implications:

• This case suggests a link between constipation, stimulant laxative use, and infantile IC.
• It underscores the importance of considering IC in infants presenting with severe gastrointestinal distress.
• This report may inform diagnostic and treatment approaches for rare pediatric gastrointestinal conditions.