Chronic idiopathic intestinal pseudo-obstruction syndrome. Radiologic signs in children with emphasis on differentiation from mechanical obstruction.

Abstract

The radiographic pattern of chronic idiopathic intestinal pseudoobstruction syndrome (CIIPS) in children includes: (a) manifestation of motility disorder, and (b) signs of bowel occlusion. The findings on plain films are identical to those of mechanical obstruction. However, when there is a clinical history of chronic symptoms of a disparity between the patient's clinical condition and the radiographic findings, opaque studies are indicated. Signs suggestive of CIIPS are: (a) an absence of stricture; (b) disorganized, decreased or absent motility in any segment of the gastrointestinal tract; (c) dilated loops of bowel, particularly the proximal portion of the duodenum (so-called superior mesenteric artery syndrome), and (d) decreased or absent haustrations and/or redundancy in the colon.