An unusual cause of idiopathic megacolon in a juvenile

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.