Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2018; 6(6): 132-138
Published online Jun 16, 2018. doi: 10.12998/wjcc.v6.i6.132
Intestinal pseudo-obstruction caused by herpes zoster: Case report and pathophysiology
Roberto Anaya-Prado, José V Pérez-Navarro, Ana Corona-Nakamura, Michelle M Anaya-Fernández, Roberto Anaya-Fernández, Marian Eliza Izaguirre-Pérez
Roberto Anaya-Prado, José V Pérez-Navarro, Department of Surgery at Western Medical Center, the Mexican Institute of Social Security, Guadalajara, JAL 44340, México
Roberto Anaya-Prado, Michelle M Anaya-Fernández, Marian Eliza Izaguirre-Pérez, Division of Research at Autonomous University of Guadalajara, Guadalajara, JAL 45200, México
Ana Corona-Nakamura, Department of Infectious Diseases at Western Medical Center, the Mexican Institute of Social Security, Guadalajara, JAL 44340, México
Roberto Anaya-Fernández, Division of Research at University of Guadalajara, Guadalajara, JAL 44340, México
Author contributions: Anaya-Prado R and Pérez-Navarro JV designed the report; Anaya-Fernández MM and Anaya-Fernández R collected the patient’s clinal data; Corona-Nakamura A and Izaguirre-Pérez ME analysed the data and wrote the paper.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Roberto Anaya-Prado, MD, PhD, FACS, Director, Division of Research at Autonomous University of Guadalajara, Blvd, Puerta de Hierro No 5150, Edificio B, Segundo Piso, Despacho 201-B. Fraccionamiento Corporativo Zapopan, CP. 45110. Zapopan, Guadalajara, JAL 45200 México. robana@prodigy.net.mx
Telephone: +52-33-38485410
Received: February 7, 2018
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
Processing time: 133 Days and 6.1 Hours
ARTICLE HIGHLIGHTS
Case characteristics

A 62-year-old male patient presented with abdominal distention and cutaneous vesicular eruption on the left side of the abdominal wall.

Clinical diagnosis

The diagnosis of intestinal pseudo-obstruction (paralytic Ileus) was made secondary to segmental paresis and visceral neuropathy caused by varicela-zoster virus (VZV) infection [herpes zoster (HZ)].

Differential diagnosis

Mechanical bowel obstruction ought to be discarded.

Imaging diagnosis

Plain X-rays and computed tomography imaging demonstrated distended small bowel loops suggestive of paralytic Ileus.

Treatment

Conservative management was established with nasogastric tube decompression, fasting, intravenous (IV) resuscitation and IV Acyclovir.

Related reports

Most reported cases of intestinal pseudo-obstruction caused by HZ involve the colon. In our case, VZV reactivation took place in the small bowel; which is still considered a very rare gastrointestinal complication.

Term explanation

VZV causes chickenpox (varicella) and HZ.

Experiences and lessons

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.