A chronic idiopathic intestinal pseudo-obstruction triggered by pregnancy

Yosuke Tajima, Tsuneo Iiai, Hitoshi Nogami, Hitoshi Kameyama, Yoshifumi Shimada, Mae Fushiki, Kazuhiko Sekine, Ai Hosoi, Katsuyoshi Hatakeyama, Hajime Umezu

Research output: Contribution to journalArticlepeer-review

Abstract

A 23-year-old woman presented with a history of repeated abdominal pain and vomiting since the 12th gestational week. Radiological studies revealed dilatation of the entire small intestine without mechanical obstruction, and dysmotility of the ileocecal region was suspected. Her symptoms continued after delivery, despite conservative treatment, and ileocecal resection was performed at age 24 years. The resected specimen showed a remarkable decrease in the density of enteric ganglion cells, therefore chronic idiopathic intestinal pseudo-obstruction (CUP) was diagnosed. Subtotal colectomy was subsequently performed at 25 years of age, but her symptoms persisted. Long-term parenteral nutrition became difficult because of catheter-related complications and her nutritional status worsened. Therefore, at age 29 she underwent jejunostomy, and her symptoms improved. She is now able to eat and her nutritional status continues to improve. Autoimmune abnormality has recently been reported to be one of the causes of CUP, and some relation between pregnancy and autoimmune disease has been recognized. Our case suggests that immunological changes during pregnancy may cause CUP.

Original languageEnglish
Pages (from-to)326-332
Number of pages7
JournalJapanese Journal of Gastroenterological Surgery
Volume45
Issue number3
DOIs
Publication statusPublished - 2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

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