PDF(Pubmed)
Abstract：
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.
摘要：
慢性假性肠梗阻（CIPO）是一种罕见的综合征，其特征是肠梗阻的体征持续6个月或更长时间，在没有明确的阻塞原因的情况下。我们报道了一例49岁女性患者的CIPO病例，该患者有6个月的持续不规则排便史。表现为便秘和腹泻伴有腹痛和腹胀的感觉。对比增强的腹部计算机断层扫描和磁共振小肠造影显示，沿乙状结肠的一段lienal曲和较宽和较窄口径的间歇性区域局灶性增厚。没有发现阻塞的明确原因，但是dolichosigma的证据被揭露了，后来通过结肠镜检查证实。由于持续的症状，患者同意择期切除乙状结肠。按照程序，症状消退，生活质量显著改善。在门诊环境中定期监测患者，并报告自手术以来没有症状。切除切片的病理生理学显示更突出的淋巴组织，卵泡排列,反应性地改变了生发中心，这可以暗示CIPO。
