2019 Volume 39 Issue 5 Pages 897-900
A 40-year-old man who was diagnosed as having ileus and had been treated for hypertension was transferred to our institution. One month prior, he had experienced paresthesia in his left femoral region and left buttock. Nine days before his visit, he developed abdominal pain and fullness. His abdominal plain X-ray image showed dilatation of the colon, and abdominal CT indicated rectal stenosis. A barium enema showed no stenosis of the rectum. We diagnosed this patient as having an acute colonic pseudo-obstruction (ACPO). Spinal cord MRI showed a spinal cord hemorrhage, and the patient recovered after conservative management and medication. In this case, factor Ⅶ deficiency was thought to contribute to the spinal cord hemorrhage. For the ACPO etiology, interference with the sympathetic-parasympathetic balance has been effective；in this case, ACPO was thought to have developed due to the damage of a sympathetic nerve in the thoracolumbar region owing to the spinal cord hemorrhage. When the diagnosis of ACPO is delayed, it may be necessary to perform emergency surgery. Therefore, it is necessary to treat patients with spinal cord lesions taking ACPO development into consideration.
