BACKGROUND When herpes zoster is complicated with paralytic ileus,this mostly involves acute intestinal pseudo-obstruction of Ogilvie’s syndrome manifesting as obvious dilatation of the cecum and right colon;small in...BACKGROUND When herpes zoster is complicated with paralytic ileus,this mostly involves acute intestinal pseudo-obstruction of Ogilvie’s syndrome manifesting as obvious dilatation of the cecum and right colon;small intestinal obstruction is rare.Here,we present a patient with a very rare case of small bowel pseudo-obstruction.CASE SUMMARY A 76-year-old female patient complained of right upper quadrant pain.Two days later,a blistering,right-sided rash of the thoracoabdominal dermatome(T5-T10) emerged in conjunction with small intestinal dilatation and the inability to defecate.Computed tomography of the abdomen confirmed small bowel pseudoobstruction.Antiviral therapy,gastrointestinal decompression,and enemas proved unproductive.After 4 d of stagnation,an epidural block was performed for pain relief and prompted the passage of gas and stool,resolving the obstructive problem.Three days later,the rash appeared dry and crusted,and the pain diminished.After 5 d,no abnormality was visible by gastroenteroscopy,and the patient was discharged on day 7.CONCLUSION This case shows that herpes zoster may induce small bowel pseudo-obstruction in addition to colonic pseudo-obstruction.Epidural block can not only treat intercostal neuralgia but also resolve small bowel pseudo-obstruction caused by herpes zoster.展开更多
Internuclear ophthalmoplegia(INO)is caused by a lesion in the medial longitudinal fasciculus.Patients with INO are usually asymptomatic but may have diplopia and oscillopsia.The most common causes of INO are ischemia ...Internuclear ophthalmoplegia(INO)is caused by a lesion in the medial longitudinal fasciculus.Patients with INO are usually asymptomatic but may have diplopia and oscillopsia.The most common causes of INO are ischemia and demyelination.Occurrence of INO due to infectious etiologies like tuberculosis,AIDS,brucellosis,cysticercosis and syphilis is well known.However,clinical presentation of INO associated with herpes zoster is very rare.The possible pathogenic mechanism for varicella zoster virus(VZV)induced INO could be demyelination or microinfarction in the brainstem.In the present study,a case of 56 years old male with double vision,with a recent history of herpes zoster,has been reported.Clinical examination revealed right INO.VZV IgM antibodies were positive and patient recovered fully after treatment with acyclovir and steroids.展开更多
文摘BACKGROUND When herpes zoster is complicated with paralytic ileus,this mostly involves acute intestinal pseudo-obstruction of Ogilvie’s syndrome manifesting as obvious dilatation of the cecum and right colon;small intestinal obstruction is rare.Here,we present a patient with a very rare case of small bowel pseudo-obstruction.CASE SUMMARY A 76-year-old female patient complained of right upper quadrant pain.Two days later,a blistering,right-sided rash of the thoracoabdominal dermatome(T5-T10) emerged in conjunction with small intestinal dilatation and the inability to defecate.Computed tomography of the abdomen confirmed small bowel pseudoobstruction.Antiviral therapy,gastrointestinal decompression,and enemas proved unproductive.After 4 d of stagnation,an epidural block was performed for pain relief and prompted the passage of gas and stool,resolving the obstructive problem.Three days later,the rash appeared dry and crusted,and the pain diminished.After 5 d,no abnormality was visible by gastroenteroscopy,and the patient was discharged on day 7.CONCLUSION This case shows that herpes zoster may induce small bowel pseudo-obstruction in addition to colonic pseudo-obstruction.Epidural block can not only treat intercostal neuralgia but also resolve small bowel pseudo-obstruction caused by herpes zoster.
文摘Internuclear ophthalmoplegia(INO)is caused by a lesion in the medial longitudinal fasciculus.Patients with INO are usually asymptomatic but may have diplopia and oscillopsia.The most common causes of INO are ischemia and demyelination.Occurrence of INO due to infectious etiologies like tuberculosis,AIDS,brucellosis,cysticercosis and syphilis is well known.However,clinical presentation of INO associated with herpes zoster is very rare.The possible pathogenic mechanism for varicella zoster virus(VZV)induced INO could be demyelination or microinfarction in the brainstem.In the present study,a case of 56 years old male with double vision,with a recent history of herpes zoster,has been reported.Clinical examination revealed right INO.VZV IgM antibodies were positive and patient recovered fully after treatment with acyclovir and steroids.
