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Chronic intestinal pseudo-obstruction as the initial feature of pure autonomic failure

¹ Department of Neurology, Chiba University, Chiba, Japan
² Department of Gastroenterology, Chiba University
³ Department of Gastroenterology, Konodai Hospital, Ichikawa, Japan
⁴ Department of Neurology, Chiba University

Correspondence to:
Correspondence to:
Dr Ryuji Sakakibara
Neurology Department, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan; sakakibara@faculty.chiba-u.jp

Keywords: autonomic failure; chronic intestinal pseudo-obstruction; lower gastrointestinal tract function; enteric nervous system

The first 150 words of the full text of this article appear below.

Chronic intestinal pseudo-obstruction (CIP) is a rare and highly morbid syndrome characterised by impaired gastrointestinal propulsion together with symptoms and signs of bowel obstruction in the absence of any lesions occluding the gut lumen (tumours, adhesive peritonitis, and so on).¹ CIP is thought to have two forms: myogenic and neurogenic.¹ Comorbid urinary retention may also occur.² Postural hypotension is not a feature in CIP. However, we recently had such a CIP patient with profound postural hypotension, which was detected only by a head up tilt test, and he was finally diagnosed as pure autonomic failure (PAF).

Case report
A 59 year old man gradually (over two months) developed intractable nausea and vomiting immediately after taking meals, although he did not have dysphagia. He also had abdominal distension, discomfort, and mild difficulty in defaecation. At that time, he had no features to suggest autonomic failure affecting other systems than the gut, such as . . . [Full text of this article]