Congenital segmental intestinal dilation in children: A case series

Congenital segmental intestinal dilation (CSID) is a rare congenital anomaly of unknown origin that can present in neonates and older children with varying clinical manifestations. CSID can only be confirmed intraoperatively, and the treatment is simple resection and anastomosis. The first case was a 17-year-old ex-premature female who presented with a longstanding history of constipation, difficulty passing stool, abdominal distension, passage of hard, tarry stool, and symptoms of anemia. She underwent repeated blood transfusions and enemas, but her symptoms persisted. Abdominal computerized tomography (CT) was suspicious for CSID. She underwent an exploratory laparotomy during which we found a segmental dilatation of the sigmoid colon. The affected sigmoid colon was resected, followed by an end-to-end anastomosis. She recovered well ans was asymptomatic at 6 months of follow up. The pathology of the specimen revealed ganglionated bowel without obvious anomalies. The second case was a 6-year-old male child who had experienced recurring intermittent abdominal pain and vomiting since the age of three years. His physical examination, abdominal radiography, and abdominal ultrasound were all unremarkable. He eventually underwent an upper gastrointestinal contrast study as part of his work-up, which was suspicious for a gastric volvulus. We took him to the operating room for an exploratory laparotomy. We found no gastric volvulus but a segmental ileal dilatation. The affected ileum was resected, followed by an end-to-end anastomosis. His recovery was uneventful. Follow-up was discontinued after 7 months of regular outpatient visits. The pathology of the specimen revealed ganglionated bowel without obvious anomalies. Congenital segmental dilation of the bowel is a rare anomaly but should be considered in children with symptom of chronic constipation and anemia.