Shirley L, Thundyil R J
Queen Elizabeth Hospital, Department of Internal Medicine, Sabah, Malaysia.
Queen Elizabeth Hospital, Department of Rheumatology, Sabah, Malaysia.
Med J Malaysia. 2017 Dec;72(6):374-375.
Intestinal pseudo-obstruction (IpsO) is defined as presence of clinical features of intestinal obstruction without identifiable mechanical obstructive lesion. IpsO is an uncommon gastrointestinal manifestation of systemic lupus erythematosus (SLE) and is largely under-recognised. There are only over 30 published cases in English literature on SLE-related IpsO. Herein, we report two cases of SLE-related IpsO to illustrate the importance of early recognition to avoid unnecessary surgical intervention, as SLE-related IpsO responds well to systemic high dose corticosteroids. These two cases also demonstrate the apparent association of IpsO with uretero-hydronephrosis, suggesting that the possible mechanism could be smooth muscle dysmotility.
肠道假性梗阻(IpsO)的定义为存在肠梗阻的临床特征但无明确的机械性梗阻病变。IpsO是系统性红斑狼疮(SLE)一种不常见的胃肠道表现,且很大程度上未得到充分认识。英文文献中关于SLE相关IpsO的已发表病例仅有30多例。在此,我们报告两例SLE相关IpsO病例,以说明早期识别对于避免不必要的手术干预的重要性,因为SLE相关IpsO对全身高剂量皮质类固醇治疗反应良好。这两例病例还显示了IpsO与输尿管肾盂积水之间明显的关联,提示可能的机制是平滑肌运动障碍。