Intestinal pseudo-obstruction

Superior mesenteric artery syndrome Enteric infections Inflammatory bowel diseases Pancreatitis Appendicitis Cholecystitis Biliary colic Gastroparesis Postvagotomy syndrome Intestinal pseudo-obstruction Functional dyspepsia Gastroesophageal reflux Peptic ulcer disease Hepatitis Peritonitis Gastric malignancy Liver failure... 

Di Lorenzo C, Flores AF, Buie T, Hyman PE Intestinal motility and jejunal feeding in children with chronic intestinal pseudo-obstruction. Gastroenterology 1995 108 1379-1385. 

Stanghellini V, Camilleri M, Malagelada JR Chronic idiopathic intestinal pseudo-obstruction Clinical and intestinal manometric findings. Gut 1987 28 5-12. 

Roy AD, Bharucha H, Nevin NC, Odling-Smee GW, Cockel R, Hill EE, et al Idiopathic intestinal pseudo-obstruction A familial visceral neuropathy. Clin Genet 1980 18 291-297. 

Khafagi FA, Lloyd HM, Gough IR Intestinal pseudo-obstruction in pheochromocytoma. AustNZ JMed 1987 17 246-248. 

Gl obstruction (Concerts only) Because the Concerts tablet is nondeformable and does not appreciably change shape in the Gl tract, do not administer to patients with pre-existing severe Gl narrowing (eg, small bowel inflammatory disease, short gut syndrome because of adhesions or decreased transit time, history of peritonitis, cystic fibrosis, chronic intestinal pseudo-obstruction, Meckel s diverticulum). 

Octreotide inhibits intestinal secretion and has dose-related effects on bowel motility. In low doses (50 meg subcutaneously), it stimulates motility, whereas at higher doses (eg, 100-250 meg subcutaneously), it inhibits motility. Octreotide is effective in higher doses for the treatment of diarrhea due to vagotomy or dumping syndrome as well as for diarrhea caused by short bowel syndrome or AIDS. Octreotide has been used in low doses (50 meg subcutaneously) to stimulate small bowel motility in patients with small bowel bacterial overgrowth or intestinal pseudo-obstruction secondary to scleroderma. 

MNGIE [21] Intermittent diarrhea and intestinal pseudo-obstruction (myoneurogastrointestinal encephalopathy). Mutations in the thymidine-phosphorylase-encoding gene leads to multiple mtDNA deletion and anomalies in mtDNA synthesis. 

Paraneoplastic autonomic neuropathy is primarily seen with SCLC [103]. Lymphoma, non-small cell lung cancer, and ovarian cancer are also associated with autonomic disturbances [104]. Autonomic dysfunction affects 23-30% of Hu antibody positive patients [36, 98] and is the predominant symptom at presentation in up to 9% of the patients [90]. The onset of symptoms is usually subacute. A prominent clinical manifestation in patients with paraneoplastic autonomic neuropathy is gastrointestinal dysmotility and intestinal pseudo-obstruction, which can occur as part of the PEM/SN syndrome or as the sole symptom of Hu antibody related PNS. Ortostatic hypotension and erectile dysfunction are other common features [37, 105, 106], Autonomic neuropathy is also commonly associated with the CRMP-5 antibody and have been detected in more than 30% of CRMP-5 antibody positive patients [30], Inflammation in autonomic ganglia and infiltration of B and T cells have been demonstrated at autopsy [107], and Hu antibodies have been shown to induce neuronal apoptosis in cultured myenteric neurons [105],... 

Viallard JF, Vincent A, Moreau JF, Parrens M, Pellegrin JL, Ellie E. Thymoma-associated neuromyotonia with antibodies against voltage-gated potassium channels presenting as chronic intestinal pseudo-obstruction. Eur Neurol 2005 53(2) 60-63. 

The possibility of fatal intestinal dilatation, although very rare, warrants careful evaluation of persistent complaints of constipation, particularly in patients who also have vomiting and abdominal pain, distension, or tenderness (518). Acute intestinal pseudo-obstruction (Ogilvie s syndrome) has been reported in a patient taking haloperidol plus benzatropine (519). 

Sheikh RA, Prindiville T, Yasmeen S. Haloperidol and benztropine interaction presenting as acute intestinal pseudo-obstruction. Am J Gastroenterol 2001 96(3) 934-5. 

Intestinal pseudo-obstruction has been attributed to fludarabine in a 66-year-old man with non-Hodgkin s lymphoma it was successfnUy managed with a combination of parasympathomimetic drngs and mechanical decompression (14). 

Campbell S, Thomas R, Parker A, Ghosh S. Fludarabine induced intestinal pseudo-obstruction case report and literature review. Eur J Gastroenterol Hepatol 2000 12(6) 711-13. 

Vargas JH, Sachs P, Ament ME. Chronic intestinal pseudo-obstruction syndrome in pediatrics Results of a national survey by members of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr 1988 7 323-332. 

A woman taking methadone 140 mg daily for 6 years to manage pain due to chronic intestinal pseudo-obstruction was admitted to hospital because of a urinary tract infection and given ciprofloxacin 750 mg twice daily. Two days later she became sedated and confused. Ciprofloxacin was replaced with co-trimoxazole and the patient recovered within 48 hours. She was treated with ciprofloxacin for recurrent urinary-tract infections a further three times and on each occasion the patient bwame sedated, with her normal alertness regained on discontinuing ciprofloxacin. On the last oc-... 

In 1990, the CSM in the UK noted that, of 26 reports they had on record of hypokalaemia with unnamed xanthines or beta2 agonists, 9 occurred in patients receiving both groups of drugs. In 5 of these 9 cases, the hypokalaemia had no clinical consequence. However, in 2 cases it resulted in cardiorespiratory arrest, in another case confusion, and in a further case intestinal pseudo-obstruction. ... 

Constipation 203 Functional Constipation 203 Neurogenic Constipation 204 Hirschsprung s Disease 204 Chronic Intestinal Pseudo-obstruction 204 Imaging in Constipation 205 Imaging Findings in Hirschsprung s Disease 205... 

Imaging Findings in NID, Hypoganglionosis, Chronic Intestinal Pseudo-obstruction,... 

Causes of constipation in infants and children include functional constipation, neurogenic constipation [aganglionosis, hypoganglionosis, neuronal intestinal dysplasia (NID)], chronic intestinal pseudo-obstruction, disorders of the spinal cord, cerebral palsy, constipation secondary to anal fissures and strictures, neonatal hypothyroidism and drug induced constipation (Potter 1998). 

Chronic intestinal pseudo-obstruction is a rare clinical condition also known as chronic adynamic ileus, pseudo-Hirschsprung s disease, and adynamic bowel syndrome. Megacystis-microcolon-intestinal hypoperistalsis syndrome is the most severe form of chronic intestinal pseudo-obstruction. 

Onset of chronic intestinal pseudo-obstruction can be at any age but tends to be more severe with the earlier presentation. In the neonatal period symptoms include failure to pass meconium, abdominal distention or bilious vomiting. Constipation may subsequently develop. In older children presenta-... 

In ultra-short segment Hirschsprung s disease the barium enema may show a large mega-rectum but no other specific findings. In NID, chronic intestinal pseudo-obstruction and total colonic agangiionosis the barium enema is often non-contributory. However, total colonic agangiionosis may sometimes have the appearance of a microcolon and therefore needs to be differentiated form ileal atresia and meconium ileus. 

Recently a new copper transport defect was described by Buchmann et al. [16] in a patient with symptoms of a demyelinating neuropathy, chronic intestinal pseudo-obstruction, osteoporosis, testicular failure, retinal degeneration and a cardiomyopathy with a tortuous aorta. In this patient, copper could not be incorporated into ceruloplasmin. The symptoms started at age 10 and the patient died at 21 years. These findings were clearly different from Wilson s and Menkes diseases. 

---