Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Feb 14, 2008; 14(6): 954-959
Published online Feb 14, 2008. doi: 10.3748/wjg.14.954
Intestinal pseudo-obstruction: An uncommon condition with heterogeneous etiology and unpredictable outcome
Eugen Florin Georgescu, Ion Vasile, Reanina Ionescu
Eugen Florin Georgescu, Reanina Ionescu, Filantropia University Hospital from Craiova, Department of Internal Medicine 2, University of Medicine and Pharmacy of Craiova, Romania
Ion Vasile, Departmental Emergency University Hospital from Craiova, Department of General Surgery 2, University of Medicine and Pharmacy of Craiova, Romania
Correspondence to: Dr. EF Georgescu, Filantropia University Hospital, Department of Internal Medicine 2, Str. Constantin Brancusi nr. 3, Craiova 200136, Romania. efg@usa.net
Telephone: +40-251-420896
Received: October 16, 2007
Revised: November 23, 2007
Published online: February 14, 2008
Abstract

Intestinal pseudo-obstruction (IPO) either acute or chronic is a condition including features of intestinal ileus in absence of mechanical obstruction. Our paper presents such a rare case of idiopathic IPO in a 53-year-old male patient with recurrent episodes of pseudo-obstruction, which were successfully resolved by anticholinesterase agents, motilin agonists or colonic decompression. However, the patient finally underwent total colectomy. Huge colonic dilatation was identified intraoperatively, while histology showed a neuropathic variant of chronic intestinal pseudo-obstruction. Etiologic mechanisms and current therapeutic methods are reviewed in this paper, which concludes that IPO is a condition in which conservative treatment usually fails. Total colectomy with ileoanal pouch may be the only solution in these situations.

Keywords: Intestinal pseudo-obstruction; Anticholinesterase agents; Motilin receptor agonists; Colonoscopic decompression; Total colectomy with ileoanal pouch