Two cases of intestinal pseudo-obstruction with systemic sclerosis

Systemic sclerosis (SSc) affects many organs and results in sclerotic changes, but intestinal pseudo-obstruction is rare complication. We presented two SSc patients with intestinal pseudo-obstruction, which is characterized bythe signs and symptoms of intestinal obstruction without true obstruction. Case 1: A 59-year-old female with a 15-year history of diffuse type SSc. She presented with abdominal pain and diarrhea in August 2010. Abdominal X-p and computed tomography showed intestinal dilation and air-fluid level. Because no intestinal obstruction was detected, we diagnosed this condition as intestinal pseudo-obstruction with SSc. By fasting and transfusion, the symptoms were improved. Case 2: A 63-year-old female was diagnosed as SSc in 2008. She experienced bouts of diarrhea in May 2010. Abdominal imaging reveald dilated loops of bowel and air-fluid level without intestinal obstruction. Intestinal pseudo-obstruction with SSc was diagnosed. Fasting and transfusion as well as cyclophosphamide intravenous administration improved the symptoms. Gastrointestinal tract symptoms occurre in more than 80% of SSc patient. However, intestinal pseudo-obstruction is rare. Our cases and previous reports suggest that primary treatment of intestinal pseudo-obstruction with SSc is fasting and transfusion in a hospital.