Published online Jun 16, 2018. doi: 10.12998/wjcc.v6.i6.132
Peer-review started: February 8, 2018
First decision: April 13, 2018
Revised: April 27, 2018
Accepted: May 15, 2018
Article in press: May 15, 2018
Published online: June 16, 2018
Herpes zoster (HZ) infection occurs in approximately 10% to 30% of individuals. Visceral neuropathies secondary to HZ can cause cystitis and urinary retention. But colonic pseudo-obstruction can also occur. Peripheral neuropathy may reveal segmental motor paresis of either upper or lower limbs, the abdominal muscles or the diaphragm. We report the case of a 62-year-old male patient who presented with abdominal distention and cutaneous vesicular eruption on the left side of the abdominal wall. Plain X-rays and computed tomography scan showed distended small bowel. A diagnosis of intestinal pseudo-obstruction was made secondary to segmental paresis of the small intestine and visceral neuropathy. Conservative management was successful and the patient was discharged uneventfully. Intestinal pseudo-obstruction ought to be considered when dealing with non-obstructive (adynamic) conditions of the digestive tract associated with HZ infection; since early recognition may help to avoid unnecessary surgery.
Core tip: Ogylvie’s syndrome secondary to herpes zoster has been reported as a rare non-surgical complication; but paralytic ileus has received little attention after varicella-zoster reactivation. We report the case of intestinal pseudo-obstruction secondary to small bowel paresis. Possible mechanisms for small bowel involvement and pathophysiology are deeply analysed.