Intestinal pseudo-obstruction caused byGiardia lambliainfection

Abstract

A woman in her 40s presented with malaise, nausea, reduced appetite, abdominal distention, loose stools and weight loss. Symptoms had started 6 months earlier and worsened in the last 2 weeks. CT enterography showed hypotonic dilated small bowel loops in absence of any mechanical obstruction. Endoscopic examinations including capsule endoscopy did not reveal any obstructing lesion, but a delayed small bowel transit time of the capsule. Duodenal histology revealed Marsh 3a villous atrophy. Secondary causes of intestinal pseudo-obstruction and villous atrophy were investigated.Giardia lambliatrophozoites were found in the stools and in the duodenal biopsies. The patient’s symptoms quickly resolved after metronidazole treatment with complete normalisation of duodenal histology.

Paraneoplastic gastrointestinal dysmotility due to non-Hodgkin diffuse large B cell lymphoma: a case report

“…Intestinal pseudoobstruction has been reported rarely in association with CVID [5] and recurrent Giardia infection [6]. In the present case, it is challenging to determine conclusively whether paraneoplastic phenomenon from lymphoma was the sole cause of pseudoobstruction, or whether other conditions contributed.…”