Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2024; 12(6): 1138-1143
Published online Feb 26, 2024. doi: 10.12998/wjcc.v12.i6.1138
Postoperative abdominal herpes zoster complicated by intestinal obstruction: A case report
Zhen-Yu Dong, Rui-Xian Shi, Xiao-Biao Song, Ming-Yue Du, Ji-Jun Wang
Zhen-Yu Dong, Xiao-Biao Song, Ji-Jun Wang, Department of General Surgery, Baotou Central Hospital, Baotou 014040, Inner Mongolia Autonomous Region, China
Zhen-Yu Dong, Ming-Yue Du, Department of General Surgery, Baotou Medical College, Baotou 014040, Inner Mongolia Autonomous Region, China
Rui-Xian Shi, Department of Neurology, Baotou Central Hospital, Baotou 014040, Inner Mongolia Autonomous Region, China
Rui-Xian Shi, Department of Neurology, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China
Co-first authors: Zhen-Yu Dong and Rui-Xian Shi.
Author contributions: Dong ZY and Shi RX analyzed the data and wrote the manuscript; Dong ZY, Shi RX and Wang JJ designed the research study; Dong ZY, Shi RX and Du MY performed the research; Song XB contributed new reagents and analytic tools; Dong ZY and Shi RX contributed equally to this work as co-first authors; All authors have read and approve the final manuscript.
Informed consent statement: All study participants or their legal guardian provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicting interests to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ji-Jun Wang, MD, Chief Physician, Department of General Surgery, Baotou Central Hospital, No. 61 Huan Cheng Road, Donghe District, Baotou 014040, Inner Mongolia Autonomous Region, China. wangjijun2004@sina.com
Received: October 7, 2023
Peer-review started: October 7, 2023
First decision: December 8, 2023
Revised: January 6, 2024
Accepted: January 29, 2024
Article in press: January 29, 2024
Published online: February 26, 2024
Abstract
BACKGROUND

Intestinal obstruction is a common occurrence in clinical practice. However, the occurrence of herpes zoster complicated by intestinal obstruction after abdominal surgery is exceedingly rare. In the diagnostic and treatment process, clinicians consider it crucial to identify the primary causes of its occurrence to ensure effective treatment and avoiding misdiagnosis.

CASE SUMMARY

Herein, we present the case of a 40-year-old female patient with intestinal obstruction who underwent laparoscopic appendectomy and developed herpes zoster after surgery. Combining the patient's clinical manifestations and relevant laboratory tests, it was suggested that the varicella zoster virus reactivated during the latent period after abdominal surgery, causing herpes zoster. Subsequently, the herpes virus invaded the visceral nerve fibers, causing gastrointestinal dysfunction and loss of intestinal peristalsis, which eventually led to intestinal obstruction. The patient was successfully treated through conservative treatment and antiviral therapy and subsequently discharged from the hospital.

CONCLUSION

Pseudo-intestinal obstruction secondary to herpes zoster infection is difficult to distinguish from mechanical intestinal obstruction owing to various causes. In cases of inexplicable intestinal obstructions, considering the possibility of a viral infection is essential to minimize misdiagnosis and missed diagnoses.

Keywords: Herpes zoster, Pseudo-intestinal obstruction, Ogilvie syndrome, Peripheral motor neuropathy, Case report

Core Tip: Herpes zoster may induce a rare pseudo-obstruction of the small intestine in addition to pseudo-obstruction of the colon. We highlight an extremely rare case of a patient with small bowel pseudo-obstruction caused by herpes zoster after abdominal surgery. More unusual, this patient presented with intestinal symptoms after the onset of rash. In cases of inexplicable intestinal obstructions, considering the possibility of a viral infection is essential to minimize misdiagnosis and missed diagnosis.