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Features Distinguishing Pediatric Condition Falsification from Chronic Intestinal Pseudo-Obstruction in Young Children

Description

Chronic intestinal pseudo-obstruction (CIPO) occurs with a variety of neuromuscular disorders and involves signs and symptoms of bowel obstruction without luminal obstruction. A parent or guardian trying to falsify a child's condition may select this condition to mimic since the clinical findings can be easily fabricated. Hyman et al identified historical and objective findings that should raise the possibility of condition falsification in a small child presenting as intestinal pseudo-obstruction.


 

Clues to possible disease falsification:

(1) daily abdominal pain

(2) illness involves 3 or more organ systems

(3) an accelerating disease trajectory (progressive requirement for increasingly invasive means of nutritional support)

(4) reported history of preterm birth, especially if medical records contradict

(5) absence of dilated bowel on abdominal X-rays

(6) normal antroduodenal manometry (with normal migrating motor complexes)

(7) no urinary neuromuscular disease

 

where:

• The first 4 findings are commonly found in cases of condition falsification.

• The last 3 findings are objective findings that would be unusual for CIPO.

 

If one or more of these findings are present, then an evaluation for possible condition fabrication should be conducted.

 


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Specialty

ICD-10