An unusual cause of idiopathic megacolon in a juvenile: A case report

RATIONALE: Idiopathic megacolon (IMC) is a rare condition in young children. The association of indigestible food and IMC has never been mentioned in literature. PATIENT CONCERNS: An 11-year-old boy reported with a 1-year duration of intermittent constipation and abdominal distension after having eaten a large amount of fried sticky rice in 1 consumption. DIAGNOSES: Chronic low colonic obstruction, IMC and malnutrition. INTERVENTIONS: This patient was managed conservatively for 1 week at first. Then he underwent loop ileostomy since conservative therapy was poorly tolerated. Enteral decompression, gut biopsy, peritoneal lavage, and drainage were performed in the same procedure. OUTCOMES: Rapid weight gain was observed 4 months after operation. LESSONS: IMC is difficult to diagnose due to the lack of specific clinical manifestations and pathological features. The protocols for management of IMC remains controversial. To achieve a good long-term outcome, early intervention is recommended.