Abstract
A 63-year-old woman with past history of radical hysterectomy 8 years before, suffered from abdominal fullnes, pain, and bladder dysfunction. The laparoscopic examination revealed normal peristalsis of small intestine and colon with no adhesive ileus. The patient was not cured persistently. A diagnosis of ‘rectal stenosis’ was made subsequently, and laparoscopic low anterior resection was performed. The patient wasnʼt cured again, and metallic stent was inserted in the rectum on the diagnosis of ‘anastomotic stenosis’. The strange obstruction continued to deteriorate, and a diagnosis of postoperative chronic paralytic ileus resembling chronic idiopathic intestinal pseudo-obstruction was made subsequently. Metoclopramide and some drugs were administrated after Hartmann operation. The medicaments were effective, and the patient got better, and kept good nutrition. On Japanese diagnostic criteria of chronic idiopathic intestinal pseudo-obstruction (CIIP), a postoperative case is commonly excluded. Five female who had the long disease duration, were only reported. It took for a long period to diagnose the postoperative chronic paralytic ileus resembling CIIP (PCPI) due to difficulty of differential diagnosis, and most cases were treated based on the treatment of CIIP. Agile and accurate diagnosis for PCPI would contribute to shorten the disease duration although PCPI is excluded from CIIP on Japanese diagnostic criteria.
