title: A case of chronic intestinal pseudo-obstruction secondary to primary visceral myopathy.
abstract: BACKGROUND
  A 13-year-old girl presented to the emergency room at her local hospital with an acute onset of vomiting, severe abdominal pain and distension. There was evidence of small-bowel obstruction on plain abdominal x-ray. Throughout the girl's adolescent years she was admitted to hospital numerous times for recurrent abdominal symptoms and underwent multiple sequential laparotomies. She had marked weight loss and a poor quality of life. The patient's symptoms were initially managed with intravenous fluids, bowel rest, and nasogastric decompression of the upper gut.
  
  
  METHODS
  Peripheral blood tests with biochemistry and measurement of serum folate, vitamin B(12), albumin, 25-hydroxyvitamin D, inflammatory markers, autoantibodies and thyroid function; gastrointestinal imaging (plain abdominal x-ray, small-bowel series, colonic transit study, and abdominal CT with oral contrast); MRI of the brain and lumbar puncture; upper endoscopy; and laparotomy with sero-muscular biopsy of the small bowel.
  
  
  METHODS
  Chronic intestinal pseudo-obstruction secondary to primary visceral myopathy.
  
  
  RESULTS
  Prokinetic agents including oral cisapride and tegaserod, a venting gastrostomy, and total parenteral feeding.
authors.affiliation: Department of Gastroenterology, Nepean Hospital, Penrith, NSW, Australia.
authors.forename: Lisa S E
authors.initials: LS
authors.lastname: Shim
authors.forename: Guy D
authors.initials: GD
authors.lastname: Eslick
authors.forename: Alex E
authors.initials: AE
authors.lastname: Kan
authors.forename: Jamshid S
authors.initials: JS
authors.lastname: Kalantar
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002908:Chronic Disease; D020117:Cisapride / Q000008:administration & dosage; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage; D006801:Humans; D007211:Indoles / Q000008:administration & dosage; D007418:Intestinal Pseudo-Obstruction / Q000150:complications* / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D010289:Parenteral Nutrition, Total; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
chemical_list: D005765:Gastrointestinal Agents; D007211:Indoles; D017366:Serotonin Receptor Agonists; C105050:tegaserod; D020117:Cisapride