[Probable amanita phalloides poisoning with pseudo-obstructive, paralytic ileus (Ogilvie's syndrome)]

A man of 52 years was admitted to Warsaw Poison Control Centre because of the suspicion of amanita phalloides poisoning. At admission (on third day of mushrooms ingestion) the patient still suffered from gastroenterocolic symptoms, especially from epigastric pain, nausea and vehement but slowly withdrawing diarrhea. On the next 2 days of hospitalization the typical symptoms of liver damage developed (jaundice, elevated aminotransferases AST and ALT, decrease of Quick index); prolonged epigastric pain was radiating to the right lower quadrant and with local tenderness peritonismus. These clinical symptoms, physical examination and abdominal x-ray suggested a "silent abdomen" due to the of obturative ileus. Therefore laparatomy was performed immediately and the adynamic ileus, not obturation of intestine, was recognized definitely. Subsequently the clinical status of the patient, previously severe, improved, blood parameters of liver damage subsided. After three weeks of hospitalization the patient was dismissed in good condition.