Acute, severe constipation in a 58-year-old Japanese patient.

摘要

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 that might cause severe bowel dysfunction. He had no bladder dysfunction. Magnetic resonance imaging of the spinal cord was normal. Two weeks after disease onset colonic transit time (CTT) was assessed using radio-opaque markers. This showed greatest delay in the right colon (figure 2).