Presentation
Long-standing abdominal pain. Not passed stool for 3 weeks.
Patient Data
The entire small bowel is dilated to about 4 cm, with some loops reaching 5cm. The dilatation extends to the ileocecal junction with no ileocecal junction stenosis, wall thickening, or mass. The lumen is mostly gas-filled but also filled with fluid-filled fecal matter, which does not appear taut. The small bowel wall shows mild global thickening similar to the wall hypertrophy noted in chronic obstruction.
The cecum is gas-filled with a diameter of 6 cm, with the ascending colon diameter reducing gradually.
The transverse colon and left colon are all empty and collapsed.
Case Discussion
Chronic intestinal pseudo-obstruction is characterized by the inability of the intestinal tract to propel its contents, resulting in a radiological appearance similar to intestinal obstruction but in the absence of any obstructive lesion 1. This syndrome can affect any part of the tract, with a high prevalence in the small and large bowels. It can be either acute or chronic 2.
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