Omullo FP, Mutisya N, Kinas E, Kitheghe T, Hassan Z, Muhonja R. Organophosphate poisoning presenting with paralytic ileus: A case report. World J Clin Pediatr 2025; 14(3): 106463 [DOI: 10.5409/wjcp.v14.i3.106463]
Corresponding Author of This Article
Felix Pius Omullo, MD, Researcher, Department of Pediatrics and Child Health, Murang’a County Referral Hospital, Hospital Road, Kiharu Township, Murang’a 10200, Kenya. piuskirasia@gmail.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Sep 9, 2025; 14(3): 106463 Published online Sep 9, 2025. doi: 10.5409/wjcp.v14.i3.106463
Organophosphate poisoning presenting with paralytic ileus: A case report
Felix Pius Omullo, Nick Mutisya, Elisha Kinas, Thomas Kitheghe, Zamzam Hassan, Rynah Muhonja
Felix Pius Omullo, Nick Mutisya, Elisha Kinas, Thomas Kitheghe, Zamzam Hassan, Rynah Muhonja, Department of Pediatrics and Child Health, Murang’a County Referral Hospital, Murang’a 10200, Kenya
Co-first authors: Felix Pius Omullo and Nick Mutisya.
Author contributions: Omullo FP and Mutisya N drafted the manuscript and made equal contributions as co-first authors. Omullo FP contributed to conceptualization and data collection; Mutisya N contributed to literature review, editing, and critical revision; Kinas E contributed to data interpretation, case presentation refinement, and manuscript review; Kitheghe T contributed to manuscript formatting, figure preparation, and reference management; Hassan Z and Muhonja R contributed to supervision, critical revision, and final approval of the manuscript.
Informed consent statement: Written informed consent was obtained from the patient’s parent for publication of this case report and accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Felix Pius Omullo, MD, Researcher, Department of Pediatrics and Child Health, Murang’a County Referral Hospital, Hospital Road, Kiharu Township, Murang’a 10200, Kenya. piuskirasia@gmail.com
Received: March 6, 2025 Revised: April 23, 2025 Accepted: May 29, 2025 Published online: September 9, 2025 Processing time: 102 Days and 17 Hours
Abstract
BACKGROUND
Organophosphate (OP) poisoning is common in sub-Saharan Africa. It is associated with high mortality and morbidity. Affected individuals often exhibit cholinergic symptoms and respiratory distress. Moreover, other complications, such as pancreatitis, arrhythmias, and hepatic dysfunction, have been reported. However, paralytic ileus is an exceedingly rare complication.
CASE SUMMARY
We report a case of a 5-year-old boy who presented with altered sensorium and abdominal distension following suspected OP exposure. Physical examination and imaging revealed features of intestinal obstruction and neurological deficits. He was managed with atropine, pralidoxime, and other supportive measures and had a successful recovery. Paralytic ileus is an atypical complication of acute OP poisoning. The resultant intestinal obstruction manifests as cholinergic overactivity, leading to bowel dysmotility. This case emphasizes the need for awareness and prompt management of such atypical presentations, especially in the pediatric population.
CONCLUSION
Timely recognition and multidisciplinary management of atypical presentations, such as paralytic ileus, are crucial in improving outcomes in pediatric OP poisoning.
Core Tip: This case report describes a rare presentation of paralytic ileus following organophosphate poisoning in a 5-year-old boy. Clinical suspicion and imaging confirmed the diagnosis despite the absence of overt cholinergic signs. Prompt treatment with atropine, pralidoxime, and supportive measures led to full recovery. The report highlights the importance of recognizing atypical complications, especially in pediatric patients, and calls for improved harm reduction strategies, public awareness, and safe pesticide storage to prevent such incidents in resource-limited settings.
