May 1990

Lead Poisoning Presenting as Intestinal Ileus in a Child

Author Affiliations

Division of Gastroenterology and Nutrition Department of Pediatrics University of Texas Southwestern Medical Center at Dallas 5323 Harry Hines Blvd Dallas, TX 75235-9063

Am J Dis Child. 1990;144(5):524-526. doi:10.1001/archpedi.1990.02150290018015

Sir.—Lead poisoning in children most commonly presents with clinical symptoms and signs related to central and peripheral nervous system toxicities. Hematologic and renal toxicities may also be manifested. Lead toxicity to these systems is well recognized and frequently described in the literature.1 In contrast, gastrointestinal symptoms and signs commonly are present but are less well recognized. Intermittent constipation, vomiting, and intense colicky abdominal pain may occur; in adults, the so-called lead colic syndrome may be the only clinical manifestation of excess lead absorption.2,3 Intestinal hypomotility induced by lead may be sufficiently severe that affected adults sometimes have a misdiagnosis of mechanical intestinal obstruction or another surgical disorder of the abdomen. We describe a child with acute lead poisoning who presented with unremitting paralytic intestinal ileus as the primary clinical feature. To our knowledge, intestinal ileus due to gastrointestinal lead toxicity has not heretofore been reported to occur

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