Anaya-Prado R, Pérez-Navarro JV, Corona-Nakamura A, Anaya-Fernández MM, Anaya-Fernández R, Izaguirre-Pérez ME. Intestinal pseudo-obstruction caused by herpes zoster: Case report and pathophysiology. World J Clin Cases 2018; 6(6): 132-138 [PMID: 29988868 DOI: 10.12998/wjcc.v6.i6.132]
Corresponding Author of This Article
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
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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/
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
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.
