Intestinal pseudo-obstruction--a rare condition with heterogeneous etiology and unpredictable outcome. A case report.

Intestinal pseudo-obstruction (IPO), either acute or chronic, is a condition including features of intestinal ileus in the absence of mechanical obstruction. We present such a rare case of idiopathic IPO in a 53-year old male patient in whom recurrent episodes of pseudo-obstruction were successfully resolved by anticholinesterase agents, motilin agonists or colonic decompression. However, subsequently total colectomy was required. Huge colonic dilatation was identified intraoperatively, while histology evidenced a neuropathic variant of chronic intestinal pseudoobstruction. IPO is a condition in which conservative treatment usually fails. Total colectomy with ileoanal pouch was the solution in our patient.