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Child Maltreatment
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Discriminating Pediatric Condition Falsification from Chronic Intestinal Pseudo-Obstruction in Toddlers

Paul E. Hyman

Kansas University Medical Center

Brenda Bursch

UCLA School of Medicine

David Beck

UCLA School of Medicine

Carlo DiLorenzo

Pittsburgh Children's Hospital

Lonnie K. Zeltzer

UCLA Children's Hospital

Pediatric condition falsification may masquerade as chronic and serious digestive disease, including chronic intestinal pseudo-obstruction. The purpose of this study was to define clinical criteria to discriminate between these two conditions. We compared medical records of 8 pediatric condition falsification victims to those of 14 children with chronic intestinal pseudo-obstruction. Clinical features suggesting pediatric condition falsification in toddlers presenting with chronic and severe digestive complaints included (a) daily abdominal pain, (b) illness involving three or more organ systems, (c) an accelerating disease trajectory, (d) a reported history of preterm birth, (e) absence of dilated bowel on x-ray, (f) normal antroduodenal manometry, and (g) no urinary neuromuscular disease. These results suggest that a diagnosis of pediatric condition falsification may be suspected in toddlers presenting with a phenotype for enteric neuromuscular disorders by features in the clinical history, symptoms, and signs.

Child Maltreatment, Vol. 7, No. 2, 132-137 (2002)
DOI: 10.1177/1077559502007002005
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