Ileus Asim Maqbool Chris A Liacouras Ileus is the failure of intestinal peristalsis caused by loss of coordinated gut motility without evidence of mechanical obstruction. In children, it is most often associated with abdominal surgery or infection (gastroenteritis, pneumonia, peritonitis). Ileus also accompanies metabolic abnormalities (e.g., uremia, hypokalemia, hypercalcemia, hypermagnesemia, acidosis) or administration of certain drugs, such as opiates, vincristine, and antimotility agents such as loperamide when used…

Chronic Intestinal Pseudoobstruction Asim Maqbool Kristin N. Fiorino Chris A. Liacouras Chronic intestinal pseudoobstruction (CIPO) comprises a group of primary and secondary disorders characterized as a motility disorder with the dominant defect of impaired peristalsis; symptoms are consistent with intestinal obstruction in the absence of mechanical obstruction ( Table 358.1 ). The natural history of primary pseudoobstruction is that of a progressive disorder, although there are occasional cases of…

Intestinal Duplication Asim Maqbool Chris A. Liacouras Duplications of the intestinal tract are rare anomalies that consist of well-formed tubular or spherical structures firmly attached to the intestine with a common blood supply. The lining of the duplications resembles that of the gastrointestinal (GI) tract. Duplications are located on the mesenteric border and can communicate with the intestinal lumen. Duplications can be classified into three categories: localized duplications,…

Hypertrophic Pyloric Stenosis Asim Maqbool Chris A. Liacouras Hypertrophic pyloric stenosis occurs in 1-3/1,000 infants in the United States. It is more common in whites of northern European ancestry, less common in blacks, and rare in Asians. Males (especially firstborns) are affected approximately 4-6 times as often as females. The offspring of a mother and, to a lesser extent, the father who had pyloric stenosis are at higher…

Foreign Bodies in the Esophagus Seema Khan The majority (80%) of accidental foreign-body ingestions occur in children, most of whom are 5 yr of age or younger. Older children and adolescents with developmental delays and those with psychiatric disorders are also at increased risk. The presentation of a foreign body lodged in the esophagus constitutes an emergency and is associated with significant morbidity and mortality because of the…

Esophageal Atresia and Tracheoesophageal Fistula Seema Khan Sravan Kumar Reddy Matta Keywords VACTERL polyhydramnios Esophageal atresia (EA) is the most common congenital anomaly of the esophagus, with a prevalence of 1.7 per 10,000 live births. Of these, >90% have an associated tracheoesophageal fistula (TEF). In the most common form of EA, the upper esophagus ends in a blind pouch and the TEF is connected to the distal esophagus…