Chronic Intestinal Pseudo-Obstruction in Patients with Extensive Bowel Resection for Crohn's Disease

Abstract

We report three cases of severe chronic intestinal pseudo-obstruction after extensive bowel resection for Crohn's disease. The patients retained ≤ 150 cm jejunum in continuity with the left half of the colon and had no evidence of inflammatory activity in the remaining bowel. Total parenteral nutrition was required, since even very small meals caused abdominal distention, pain, and vomiting. Two patients had a sigmoidostomy constructed, which alleviated the symptoms and enabled a nor-al oral intake, but only temporarily in one of the patients. Even with a sigmoidostomy the patients needed supplementary parenteral nutrition, because of severe malabsorption with high stomal output.

Key Words:

• Chronic intestinal pseudo-obstruction
• Crohn's disease
• home parenteral nutrition
• short-bowel syndrome