Colon blockage in children under 2 years old is usually a mechanical blockage or a pseudo-obstruction. In neonates, colon blockage symptoms appear one or two days after birth, while other blockages appear after ingesting inappropriate items or in response to congenital abnormalities. Congenitally, a spectrum of digestive motility disorders and malformations can cause colon blockage in pediatric patients.
Neonates
Newborn infants, also called neonates, and preterm infants can suffer from several types of colon blockage. Neonatal necrotizing enterocolitis predominantly affects preterm infants. Sections of dead intestinal tissue cannot move digestive contents and a blockage occurs. Also, narrowed areas of intestine or anal blockage can cause a backup of waste in the colon, as well as a failure to pass meconium, the first bowel movement after birth.
Intussusception
Colon intussusception occurs when part of the colon slides into itself with a telescoping motion, which usually causes an intestinal blockage. This type of blockage is the most common intestinal blockage in children. It affects boys more often than girls and occurs in most cases at 5 months and 3 years of age. The cause of intussusception in unknown, but it is often associated with viral infections.
Fistula
An abnormal passage between two areas of the digestive tract or between the digestive tract and an organ is called a fistula. Fistulas commonly occur around the anus and colon. Some fistulas form during uterine development, while others occur secondary to trauma, surgery or infection. A fistula redirects intestinal contents, which causes pain, bloating and possibly blockage.
Intestinal Twisting or Narrowing
Sometimes, the bowel does not rotate into its proper anatomical position during embryonic development. Improper intestinal positioning can interrupt the thin tissues that hold the colon in place within the abdominal cavity. Such a floppy bowel can twist and cause a blockage. Occasionally, a child is born with a closed colon or a misplaced anal opening. Both conditions block colon function.
Pseudo-Obstruction
Pseudo-obstruction of the colon happens when the nerves or muscles involved in digestive motility do not function properly. Hirschsprungs's disease is the congenital absence of nerve networks on the intestinal wall, which causes continual muscle spasms and lack of motility. Fetal alcohol syndrome, autoimmune disease and viral infections can cause secondary intestinal nerve damage and colon blockage.
Foreign Bodies
Since young children taste and swallow various items in their environment, foreign body ingestion is likely to occur. Many times, preexisting intestinal abnormalities increase their risk of foreign body impaction. Symptoms of foreign body ingestion encompass a wide range of medical conditions and should always be a consideration in young children. Sometimes, certain components of infant milk can form intestinal blockages called lactobezoars. All foreign bodies must either pass through the colon or be surgically extracted.
References
- MedlinePlus: Intestinal Obstruction
- American Family Physician; Failure to Pass Meconium: Diagnosing Neonatal Intestinal Obstruction; Vera Loening-Bauke, M.D., and Ken Kimura, M.D
- Mayo Clinic: Intussusception
- National Digestive Diseases Information Clearinghouse: Anatomic Problems of the Colon
- Gastroenterology; Chronic Intestinal Pseudo-Obstruction: Assessment and Management; Frances L. Conor and Carlo DiLorenzo
- The Merck Manual: Jujunoileal and Large-Bowel Obstruction
- University of Hawaii: Chapter IX.7. Gastrointestinal Foreign Bodies
- Journal of Pediatrics and Adolescent Medicine; New Treatments for Intestinal Obstruction in the Newborn
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