Abstract
A 67-year-old woman with preexisting mitochondrial encephalomyopathy who had visited a nearby hospital with a complaint of epigastric pain accompanied by nausea was transferred to our department due to lack of improvement in her symptoms. Marked expansion of the proximal side of the descending colon near the splenic flexure was evident on computed tomographic images, so we suspected bowel obstruction caused by a neoplastic lesion and immediately performed colostomy. Colonoscopy performed on postoperative day 12 revealed no obvious lesion, such as a tumor, which might have caused bowel obstruction. Because no expansion of the small intestine was observed during follow-up observation, we diagnosed chronic intestinal pseudo-obstruction (CIPO) localized to the bowel and secondary to mitochondrial encephalomyopathy. CIPO is prevalent in the small intestine, and drug therapy, nutrition therapy, and decompression are the primary treatment methods. However, surgical resection such as bypass surgery is reported to be effective for CIPO localized to the bowel. Physicians should keep CIPO in mind when treating patients who present with symptoms of chronic bowel obstruction and should determine an appropriate treatment strategy for each patient based on the affected area and overall conditions.
