Cardiac arrest in two children with nonfamilial chronic intestinal pseudoobstruction on total parenteral nutrition.

Two children with nonfamilial chronic intestinal pseudoobstruction are reported. Both had no family history. They had an exploratory laparotomy to rule out mechanical intestinal obstruction, and required long-term parenteral nutrition to obtain sufficient nutrients. These two children had dilatation of the whole length of the small intestine, which differs from short segmental dilatation (megaduodenum) in patients with familial chronic intestinal pseudoobstruction. There were also differences in the histology of the gastrointestinal tract between these two patients although they had similar clinical manifestations. Both patients died from cardiac arrest, one after 2 years and the other after 4 months on long-term parenteral hyperalimentation. At autopsy, heart examination was normal in one patient, and a small infarction (0.4 mm diameter) was found in the other. Although mild hypokalemia was found in one case, and mild hyperkalemia in the other, the cause of cardiac arrest in these two children is not known.