Idiopathic intestinal pseudo-obstruction and contaminated small bowel syndrome--treatment with metronidazole, ileostomy, and indomethacin.

Abstract

A 28-year-old Iranian man with chronic idiopathic intestinal pseudo-obstruction presented with gross features of contaminated bowel syndrome. Treatment with metronidazole reversed steatorrhea but exacerbated the gaseous distention of the small intestine, precipitating emergency surgical decompression and ileostomy. A chronic high volume ileostomy diarrhea ensued and was successfully treated with oral indomethacin.