DIFFUSE DIVERTICULOSIS OF COLON WITH SPONTANEOUS PERFORATION IN A CHILD
Journal of Pediatric Gastroenterology & Nutrition:
Abstracts: Annual Meeting of the North American Society for Pediatric Gastroenterology and Nutrition; Denver, October 21-24, 1999
Department of Pediatrics, Pathology & Surgery Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI
Colonic diverticulosis is commonly seen in adults, frequently involving the sigmoid colon. Diffuse colonic diverticulosis has not been reported in pediatric population. We report a 10 year-old, white female, referred for a two week history of vomiting and severe abdominal pain. There was no history of chronic constipation, fever, diarrhea or weight loss. The patient's prior history was significant for spontaneous colonic perforation that required colostomy and resection of sigmoid colon (6cm) two years prior. An additional short segment of colon was resected due to "muscular weakness" during reanastomosis three months later. Further evaluation included a suction rectal biopsy which revealed presence of ganglion cells. No underlying etiology was determined for the colonic perforation. She had been asymptomatic until this hospitalization. An upper gastrointestinal series with small bowel follow through was normal, however a colonoscopy revealed multiple diverticula (40 or more) throughout the colon. An elective abdominal colectomy was performed due to potential risk of perforation. Gross and histological examination of the resected colon showed multiple diverticula with loss of muscularis propria and fibrous replacement. Diffuse colonic diverticulosis (congenital or acquired) should be considered in children with spontaneous colonic perforations. The awareness and prompt recognition of diverticulosis could prevent potential life threatening gastrointestinal complications.
POSTER SESSION II
Intestine/Colon/IBD© 1999 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,