A Case of Chronic Intestinal Pseudo-Obstruction Secondary to Primary Amyloidosis

Manabu Sato, Chikashi Shibata, Terutada Kobayashi, Tatsuya Ueno, Makoto Kinouchi, Munenori Nagao, Keiichi Hayashi and Iwao Sasaki

Division of Biological Regulation and Oncology, Department of Surgery, Tohoku University Postgraduate School of Medicine

We report a case of chronic intestinal pseudo-obstruction (CIP) due to primary amyloidosis. A 56-year-old man with abdominal distention and diagnosed with idiopathic CIP underwent emergency surgery after the duodenum was thought to have been perforated during re-insertion of a long intestinal tube. Although no perforation was detected in the duodenum or small intestine, the jejuoileal intestinal wall was extremely fragile, and gut-handling caused multiple perforations, necessitating resection of the small intestine for 300 cm and end jejunostomy. Pathological examination showed CIP secondary to primary amyloidosis, which caused the men's death six months later. The prognosis for CIP secondary to primary amyloidosis is dismal, with surgical intervention a last-ditch effort because destruction of the intestinal wall is go rapid.

Key words
chronic intestinal pseudo-obstruction, primary amyloidosis

Reprint requests
Manabu Sato Division of Biological Regulation and Oncology and Department of Surgery, Tohoku University Postgraduate School of Medicine
1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 JAPAN

Accepted
December 17, 2008

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