A Case of Intractable Paralytic Ileus due to Dialysis-Related Amyloidosis

Kenji Yamaguchi, Takaaki Yamane, Toshihiko Hirata and Seiji Fukuda*

Department of Surgery and Department of Pathology*, Japanese Red Cross Kumamoto Hospital

A 66-year-old man treated by hemodialysis for about 30 years repeatedly suffered from ileus in the last three years. Because endoscopic biopsy of the rectal mucosa could not detect amyloid deposition, it was unable to identify gastrointestinal amyloidosis. Admitted with a diagnosis of colonic ileus, he under went conservative treatment, but, a sigmoid colostomy did not improve the ileus. Severe amyloid deposition in the proper muscle caused the large-intestin wall to become paralyzed. In dialysis amyloidosis, such a gastrointestinal complication is believed to be caused by massive amyloid deposition in the proper muscle, making it is very difficult to locate amyloid deposition endoscopically. Dialysis amyloidosis thus becomes serious in long-term dialysis patients and may paralyze the gastrointestinal tract beyond recovery.

Key words
dialysis-related amyloidosis, paralytic ileus

Reprint requests
Kenji Yamaguchi Department of Surgery, Japanese Red Cross Kumamoto Hospital
2-1-1 Nagamineminami, Kumamoto, 862-8520 JAPAN

Accepted
January 30, 2008

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