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Acute, severe constipation in a 58-year-old Japanese patient
  1. Nobuo Hosoe1,
  2. Ryuji Sakakibara2,
  3. Masami Yoshida3,
  4. Tomoe Wakabayashi3,
  5. Hidemasa Kikuchi1,
  6. Tetsuhiro Yamada1,
  7. Kazutoshi Kawahara3,
  8. Masahiko Kishi2
  1. 1Gastroenterology Division, Department of Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
  2. 2Neurology Division, Department of Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
  3. 3Department of Dermatology, Sakura Medical Center, Toho University, Sakura, Japan
  1. Correspondence to Dr Ryuji Sakakibara, Neurology, Internal Medicine, Sakura Medical Center, Toho University, 564-1 Shimoshizu, Sakura 285-8741, Japan; sakakibara{at}sakura.med.toho-u.ac.jp

https://doi.org/10.1136/gut.2009.183392

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    Clinical presentation

    A 58-year-old Japanese patient was referred to our departments with 1 week history of severe constipation together with a painful skin eruption in his left abdomen. He had abdominal distension, pain, anorexia, and no bowel movements for 1 week at all. A plain abdominal x-ray revealed colonic dilatation but haustra only in the proximal colon (figure 1). Abdominal CT and ultrasound echography revealed no evidence of colonic spasm or obstruction. His blood tests, including C-reactive protein, were normal. Neurological examination revealed no evidences of myelopathy …

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    Footnotes

    • Competing interests None.

    • Patient consent Obtained.

    • Ethics approval This study was conducted with the approval of the Ethics Committee in Sakura Medical Center, Toho Univresity.

    • Provenance and peer review Not commissioned; externally peer reviewed.