Acta clinica Croatica, Vol. 61. No. 4, 2022.
Recenzija, prikaz
https://doi.org/10.20471/acc.2022.61.04.23
Chronic Pseudo-Obstruction of the Sigmoid Colon: A Case Report
Ivan Vulić
; Division of Gastroenterology, Department of Internal Medicine, Pula General Hospital, Pula, Croatia
Matija Šestan-Peša
; Department of Comparative Medicine, Yale University School of Medicine, New Haven, CT, USA
Dubravka Mužina Mišić
; Department of Abdominal Surgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Ivana Pavić
; Department of Pathology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Mario Živković
; Division of Gastroenterology, Department of Internal Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Ivan Budimir
; Division of Gastroenterology, Department of Internal Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Davor Hrabar
; Division of Gastroenterology, Department of Internal Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Neven Ljubičić
; Division of Gastroenterology, Department of Internal Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Marko Nikolić
; Division of Gastroenterology, Department of Internal Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Sažetak
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.
Ključne riječi
Chronic intestinal pseudo-obstruction; Dolichosigma; Constipation; Abdominal pain; Abdominal computed tomography; Abdominal magnetic resonance enterography
Hrčak ID:
302080
URI
Datum izdavanja:
1.12.2022.
Posjeta: 1.538 *