CHRONIC INTESTINAL PSEUDOOBSTRUCTION ASSOCIATED WITH FETAL ALCOHOL SYNDROME

Alcohol acts as a teratogen in the fetus, resulting in prenatal or pos tnatal growth failure, characteristic facial dysmorphic features, and central nervous system dysfunction. The toxic effects of alcohol on th e developing brain are well recognized, but gastrointestinal neuropath y has not been described in fetal alcohol syndrome (FAS). Five childre n with FAS presented in infancy with signs and symptoms suggestive of chronic intestinal pseudoobstruction. They were not able to sustain ad equate caloric intake by mouth, and all required prolonged special met hods of alimentation. We performed antroduodenal manometry in these ch ildren to determine whether their symptoms were associated with a gast rointestinal motility disorder. All patients had abnormally propagatin g phase III-like episodes during fasting (retrograde in four, simultan eous in two), Persistent clusters of stationary contractions were a pr ominent feature in two patients. In utero neurotoxicity of alcohol may not be limited to the central nervous system, but may also cause an e nteric neuropathy presenting in infancy as chronic intestinal pseudoob struction.