Abstract
Paralytic ileus is a major complication of Duchenne muscle dystrophy (DMD) which is occasionally observed in advanced stage patients. However, in a search of the literature we could not find any previous cases in which a laparotomy was performed for mechanical ileus with DMD. We recently experienced a patient with DMD who showed flequent ileus. A 31-year old man who had been bedridden since 25 years of age presented complaining of vomitting, abdominal fullness and pain. Conservative therapy proved to be ineffective and therefore a laparotomy was performed. During the operation, the right quadrant of the intraperitoneal cavity was found to be flattened while the left quadrant had completely caved in due to severe lordosis and scoliosis. In addition, a dilated jejunum was also found in the left quadrant. A tube gastrostomy and two jejunostomies were made and the postoperative course was good. Thereafter, the tubes were clamped, narrowed down, and removed 18 months after the operation. In the present case, the rate of weight loss was over 10% during the six month period before ileus developed. Therefore, a severe curvature of the spine due to DMD accompanied by a flattened intraperitoneal cavity caused by emaciation, which was similar to that caused by paralytic ileus of DMD, was thus considered to have caused the ileus observed in this patient.
