Volume 85 - 2022 - Fasc.1 - Reviews
Isolated amyloidosis of the gastro-intestinal tract
Amyloidosis is a very rare condition, which, due to its rarity, is often missed or diagnosed in an advanced stage of the disease, causing significant morbidity and mortality. In this review we describe the existing types of amyloidosis focusing on the gastro-intestinal tract. Amyloidosis occurs when abnormal protein fibrils (amyloid) deposit in the muscularis mucosae. This can cause an array of symptoms ranging from (in order of occurrence): gastro-intestinal bleeding, heartburn, unintentional weight loss, early satiety, constipation, diarrhea, nausea, vomiting and fecal incontinence (1). Treatment is focused on the underlying condition (if any) causing the production and deposition of the abnormal fibrils, in combination of symptomatic treatment.
Chronic intestinal pseudo-obstruction: a case report with review of the literature and practical guidance for the clinician
Chronic Intestinal Pseudo-obstruction (CIPO) is a rare but
debilitating and severe form of gastrointestinal dysmotility. The
diagnosis is often made very late in the disease course due to its
rarity and complexity. Treatment is mainly supportive, as there is
no definitive cure. Pharmacologic therapy comprises prokinetics,
antibiotics for bacterial overgrowth and pain management. Pain
can also be alleviated with intestinal decompression in selected
cases. Beside the pharmacologic therapy, nutrition and fluid
replacement play a key role. Rarely, intestinal transplantation
is necessary in patients with CIPO and intestinal failure. In this
review, we describe an advanced CIPO case and provide an update
of the clinical and diagnostic features and current management
strategies. The goal of our review is to raise awareness around CIPO
and to give practical guidance for the clinician.
