PDF(Pubmed)
Abstract：
BACKGROUND: When herpes zoster is complicated with paralytic ileus, this mostly involves acute intestinal pseudo-obstruction of Ogilvie\'s syndrome manifesting as obvious dilatation of the cecum and right colon; small intestinal obstruction is rare. Here, we present a patient with a very rare case of small bowel pseudo-obstruction.
METHODS: A 76-year-old female patient complained of right upper quadrant pain. Two days later, a blistering, right-sided rash of the thoracoabdominal dermatome (T5-T10) emerged in conjunction with small intestinal dilatation and the inability to defecate. Computed tomography of the abdomen confirmed small bowel pseudo-obstruction. Antiviral therapy, gastrointestinal decompression, and enemas proved unproductive. After 4 d of stagnation, an epidural block was performed for pain relief and prompted the passage of gas and stool, resolving the obstructive problem. Three days later, the rash appeared dry and crusted, and the pain diminished. After 5 d, no abnormality was visible by gastroenteroscopy, and the patient was discharged on day 7.
CONCLUSIONS: This case shows that herpes zoster may induce small bowel pseudo-obstruction in addition to colonic pseudo-obstruction. Epidural block can not only treat intercostal neuralgia but also resolve small bowel pseudo-obstruction caused by herpes zoster.
METHODS: A 76-year-old female patient complained of right upper quadrant pain. Two days later, a blistering, right-sided rash of the thoracoabdominal dermatome (T5-T10) emerged in conjunction with small intestinal dilatation and the inability to defecate. Computed tomography of the abdomen confirmed small bowel pseudo-obstruction. Antiviral therapy, gastrointestinal decompression, and enemas proved unproductive. After 4 d of stagnation, an epidural block was performed for pain relief and prompted the passage of gas and stool, resolving the obstructive problem. Three days later, the rash appeared dry and crusted, and the pain diminished. After 5 d, no abnormality was visible by gastroenteroscopy, and the patient was discharged on day 7.
CONCLUSIONS: This case shows that herpes zoster may induce small bowel pseudo-obstruction in addition to colonic pseudo-obstruction. Epidural block can not only treat intercostal neuralgia but also resolve small bowel pseudo-obstruction caused by herpes zoster.
摘要：
背景：当带状疱疹并发麻痹性肠梗阻时，这主要涉及Ogilvie综合征的急性假性肠梗阻，表现为盲肠和右结肠明显扩张；小肠梗阻很少见。这里,我们介绍了一个非常罕见的小肠假性梗阻病例。
方法：一名76岁女性患者主诉右上腹疼痛。两天后,起泡，胸腹皮刀右侧皮疹（T5-T10）伴随小肠扩张和无法排便而出现。腹部计算机断层扫描证实小肠假性梗阻。抗病毒治疗,胃肠减压,灌肠被证明是无效的。停滞4d后，硬膜外阻滞是为了缓解疼痛，并促使气体和粪便通过，解决阻碍性问题。三天后,皮疹出现干燥和结痂，疼痛减轻了。5d后,胃肠镜检查未见异常，患者在第7天出院。
结论：本病例显示带状疱疹除结肠假性梗阻外，还可诱发小肠假性梗阻。硬膜外阻滞不仅可以治疗肋间神经痛，还可以解决带状疱疹引起的小肠假性梗阻。
方法：一名76岁女性患者主诉右上腹疼痛。两天后,起泡，胸腹皮刀右侧皮疹（T5-T10）伴随小肠扩张和无法排便而出现。腹部计算机断层扫描证实小肠假性梗阻。抗病毒治疗,胃肠减压,灌肠被证明是无效的。停滞4d后，硬膜外阻滞是为了缓解疼痛，并促使气体和粪便通过，解决阻碍性问题。三天后,皮疹出现干燥和结痂，疼痛减轻了。5d后,胃肠镜检查未见异常，患者在第7天出院。
结论：本病例显示带状疱疹除结肠假性梗阻外，还可诱发小肠假性梗阻。硬膜外阻滞不仅可以治疗肋间神经痛，还可以解决带状疱疹引起的小肠假性梗阻。
