AI Article Synopsis
- A 13-year-old girl visited the emergency room with severe vomiting, abdominal pain, and bloating, displaying signs of small-bowel obstruction due to a history of recurrent abdominal issues and multiple surgeries.
- Investigative tests included blood work, various imaging studies, endoscopy, and a biopsy, which ultimately revealed she had chronic intestinal pseudo-obstruction caused by primary visceral myopathy.
- Her treatment plan involved prokinetic medications, a venting gastrostomy for stomach drainage, and total parenteral nutrition to address her nutritional needs.
Article Abstract
Background: A 13-year-old girl presented to the emergency room at her local hospital with an acute onset of vomiting, severe abdominal pain and distension. There was evidence of small-bowel obstruction on plain abdominal x-ray. Throughout the girl's adolescent years she was admitted to hospital numerous times for recurrent abdominal symptoms and underwent multiple sequential laparotomies. She had marked weight loss and a poor quality of life. The patient's symptoms were initially managed with intravenous fluids, bowel rest, and nasogastric decompression of the upper gut.
Investigations: Peripheral blood tests with biochemistry and measurement of serum folate, vitamin B(12), albumin, 25-hydroxyvitamin D, inflammatory markers, autoantibodies and thyroid function; gastrointestinal imaging (plain abdominal x-ray, small-bowel series, colonic transit study, and abdominal CT with oral contrast); MRI of the brain and lumbar puncture; upper endoscopy; and laparotomy with sero-muscular biopsy of the small bowel.
Diagnosis: Chronic intestinal pseudo-obstruction secondary to primary visceral myopathy.
Management: Prokinetic agents including oral cisapride and tegaserod, a venting gastrostomy, and total parenteral feeding.
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| http://dx.doi.org/10.1038/ncpgasthep1254 | DOI Listing |
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