Chronic Pseudo-Obstruction of the Sigmoid Colon: A Case Report

Chronic intestinal pseudo-obstruction (CIPO) is a rare syndrome characterized by signs of intestinal obstruction lasting for 6 months or more, in the absence of a definitive cause of obstruction. We report a case of CIPO in a 49-year-old female patient with a 6-month history of ongoing irregular bow...

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Published inActa clinica Croatica (Tisak) Vol. 61; no. 4; pp. 735 - 740
Main Authors Vulić, Ivan, Šestan-Peša, Matija, Mužina Mišić, Dubravka, Pavić, Ivana, Živković, Mario, Budimir, Ivan, Hrabar, Davor, Ljubičić, Neven, Nikolić, Marko
Format Journal Article
LanguageEnglish
Published Sestre Milosrdnice University Hospital and Institute of Clinical Medical Research, Vinogradska cesta c. 29 Zagreb 01.01.2022
Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
Subjects
Abdominal computed tomography
Abdominal magnetic resonance enterography
Abdominal pain
Case Reports
Chronic intestinal pseudo-obstruction
Constipation
Dolichosigma
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Summary:Chronic intestinal pseudo-obstruction (CIPO) is a rare syndrome characterized by signs of intestinal obstruction lasting for 6 months or more, in the absence of a definitive cause of obstruction. We report a case of CIPO in a 49-year-old female patient with a 6-month history of ongoing irregular bowel movements, manifested as constipation and diarrhea accompanied by abdominal pain and bloated feeling. Contrast-enhanced abdominal computed tomography and magnetic resonance enterography revealed focal thickening of a segment of the lienal flexure and intermittent areas of wider and narrower caliber along the sigmoid colon. No signs of a definitive cause of obstruction were found, but evidence for dolichosigma was revealed, which was later confirmed with colonoscopy. Due to persisting symptoms, the patient agreed to elective resection of the sigmoid colon. Following the procedure, symptoms regressed with a significant improvement in the quality of life. The patient has been regularly monitored in an outpatient setting and reports absence of the symptoms since the procedure. Pathophysiology of the resected section revealed more prominent lymphatic tissue, follicular arrangement, and reactively altered germinal centers, which can suggest CIPO.
ISSN:0353-9466
1333-9451
DOI:10.20471/acc.2022.61.04.23