Abstract
Two cases of chronic idiopathic intestinal pseudo-obstruction (CIIP) are reported. One is a 51-year-old man, and the other is a 47-year-old woman. Both patients presented with severe constipation and barium enema showed a marked dilation of the right colon, and a narrowing in the left colon. Studies done on the motility of the colon and anorectum revealed normal resting pressure profiles of the anorectom, a normal recto-anal reflex, and a normal resting tone of the collapsed colon. Administration of methacholine chloride, however, provoked large, non-propulsive movements in the collapsed colon, which were inhibited by the administration of atropin sulfate. Histologic examination disclosed a marked decrease in neurons and an increase of Schwann cells in the myenteric plexus of the collapsed colon. CIIP due to acquired visceral neuropathy localised in the left colon, was diagnosed as a result of manometric and histologic findings. One case was cured surgically, by a left hemi-colectomy, and the other was cured medically using choline antagonists and laxatives.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Naish JM, Capper WM, Brown NJ. Intestinal pseudo-obstruction with steatorrhea. Gut 1960; 1: 62–66.
Dayer NF, Dawson AM, Smith BF, Todd IP. Obstruction of the bowel due to lesion in the myenteric plexus. Br Med J 1969; 1: 686–689.
Silkin KB, Gracey M, Joske RA. Idiopathic intestinal pseudo-obstruction. Report of a case with neuropathological studies. Aust Paediatr J 1978; 14: 102–106.
Suzuki H, Matsumoto K, Amano S, Fujioka M, Honzumi M. Anorectal pressure and rectal compliance after low anterior resection. Br J Surg 1980; 67: 655–657.
Schuffler MD, Jonak Z. Chronic idiopathic intestinal pseudo-obstruction caused by a degenerative disorder of the myenteric plexus: The use of Smith's method to define the nuropathology. Gastroenterology 1982; 82: 476–486.
Schuffler MD, Bird TD, Sumi SM, Cook A. A familial neuronal disease presenting as intestinal pseudo-obstruction. Gastroenterology 1978; 75: 889–898.
Roy AD, Bharucha H, Nevin NC, Odling-Smee GW. Idiopathic intestinal pseudo-obstruction: A familial visceral neuropathy. Clin Genet 1980; 18: 291–297.
Matsui T, Iida M, Iwashita A, Kume K, Nishino N, Fuchigami T. Acquired hypoganglionosis of the colon resembling pseudo-obstruction, Report of a case. I to Cho (Stomach and Intestina) 1985; 20: 1131–1139. (in Japanese)
Schuffler MD, Leon SH, Krishnamurthy S. Intestinal pseudo-obstruction caused by a new form of visceral neuropathy: Palliation by radical small bowel resection. Gastroenterology 1985; 89: 1152–1156.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Suzuki, H., Amano, S., Matsumoto, K. et al. Chronic idiopathic intestinal pseudo-obstruction caused by acquired visceral neuropathy localised in the left colon: Report of two cases. The Japanese Journal of Surgery 17, 302–306 (1987). https://doi.org/10.1007/BF02470705
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02470705