Journal
JOURNAL OF GASTROENTEROLOGY
Volume 37, Issue 8, Pages 653-657Publisher
SPRINGER TOKYO
DOI: 10.1007/s005350200104
Keywords
rheumatoid arthritis (RA); chronic intestinal pseudoobstruction (CIPO); stoma; collagen vascular disease
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We report the first case of a chronic intestinal pseudo-obstruction (CIPO) in a patient with rheumatoid arthritis (RA) in whom a stoma was constructed at the sigmoid colon to decompress intracolonic pressure. The treatment improved quality of life in this patient, suggesting that surgical resection of the colon to decompress intracolonic pressure would be one of the options for the treatment of intractable CIPO. The resected specimen obtained from the sigmoid colon was found to be palisaded, with nuclei crowded in some areas of the inner circular muscle layer and thickened, with zonal or focal myxoid regions with interstitial fibrosis, composed of collagenous and elastic fibers, in the outer longitudinal muscle layer. Some of the smooth muscle cells in the outer longitudinal muscle layer showed mild degeneration with cytoplasmic vacuolar changes, but no inflammatory changes. However, further studies are required to determine whether these histopathological changes are unique to RA.
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