Diagnosis and management of pediatric intestinal pseudo-obstruction: A multidisciplinary approach through a case of perforated appendicitis

Pediatric intestinal pseudo-obstruction (PIPO) is a rare clinical condition characterized by signs of bowel obstruction in the absence of any mechanical narrowing or occlusion of the intestinal lumen, resulting from gastrointestinal motility dysfunction. In approximately 80% of cases, symptoms emerge within the first year of life. The etiology of PIPO may involve genetic predisposition, as well as triggering factors such as infections, surgical procedures, anesthesia, stress, and malnutrition. In this case, PIPO was diagnosed in a patient with prolonged diagnostic delay due to persistent ileus episodes following perforated appendicitis, thanks to a multidisciplinary approach. The patient responded well to neostigmine therapy. In conclusion, this case highlights the late-onset form of PIPO and emphasizes the challenges in the diagnosis and treatment process.