关键词: CIPO Children Chronic intestinal pseudo-obstruction Idiopathic Nationwide survey

Mesh : Adolescent Adult Child Child, Preschool Chronic Disease Female Humans Infant Infant, Newborn Intestinal Pseudo-Obstruction / diagnosis epidemiology Japan / epidemiology Male Population Surveillance Prevalence Prognosis Retrospective Studies Surveys and Questionnaires Young Adult

来  源:   DOI:10.1016/j.jpedsurg.2014.09.025   PDF(Sci-hub)

Abstract:
OBJECTIVE: A nationwide survey was conducted to identify the clinical presentation of pediatric chronic intestinal pseudo-obstruction (CIPO) in Japan.
METHODS: Data were collected via a questionnaire, ensuring patient anonymity, from facilities that treat pediatric gastrointestinal diseases in Japan.
RESULTS: Ninety-two responses were collected from forty-seven facilities. Sixty-two patients (28 males, 34 females) met formal diagnostic criteria for CIPO. The estimated pediatric prevalence was 3.7 in 1 million individuals. More than half the children (56.5%) developed CIPO in the neonatal period. Full-thickness intestinal specimens were available for histopathology assessment in forty-five patients (72.6%). Forty-one (91.1%) had no pathological abnormalities and were considered to be idiopathic. Patients were treated according to the local protocol of each facility. Forty-one patients (66.1%) had restricted oral intake of ordinary diets, and twenty-nine (46.8%) depended on parenteral nutrition. No therapeutic intervention, including medication and surgery, successfully improved oral food intake or obstructive symptoms. Only three patients (4.8%) died from enteritis or sepsis.
CONCLUSIONS: In Japan, pediatric CIPO is a rare, serious, and intractable disease. The prognosis with respect to survival is good, but unsatisfactory because of the need for prolonged parenteral nutrition and associated potential for restricted quality of life.
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