2018 Volume 46 Issue 1 Pages 7-15
A 66-year-old Japanese woman, with a history of suspected paralytic ileus, had suffered from abdominal distension and frequent diarrhea since 2016. She visited our hospital for the additional symptom of dysphagia, and she was admitted with suspected paralytic ileus. Although her abdominal computed tomography scan showed marked dilatation of the intestinal tract and air-fluid levels, no stenosis or obstruction was found. Her blood test showed a decreased serum albumin level. Detailed examinations for the differential diagnosis of a disease characterized both by paralytic ileus and by diarrhea were carried out, but no markedly abnormal findings were revealed by blood tests, endoscopic examination, and imaging studies. Thus, a chronic infection or a systemic disease was unlikely. However, on the basis of the diagnostic criteria, she was suspected of having chronic idiopathic pseudo-obstruction. Her symptoms were markedly improved by the administration of a poorly absorbable antibiotic and prokinetics.