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Intestinal pseudo-obstruction caused by Giardia lamblia infection
Tommaso Pessarelli1, Guido Basilisco2, Luisa Spina2
1Università degli Studi di Milano, Milano, Italy tommaso.pessarelli@unimi.it.
BMJ Case Reports
|November 2, 2022
Summary
Giardia lamblia infection can mimic intestinal pseudo-obstruction and cause villous atrophy. Prompt diagnosis and metronidazole treatment led to rapid symptom resolution and histological normalization in a patient presenting with these symptoms.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pathology
Background:
- Intestinal pseudo-obstruction presents with symptoms mimicking mechanical blockage.
- Villous atrophy, a sign of small intestinal damage, can have various secondary causes.
Observation:
- A middle-aged woman experienced chronic malaise, nausea, abdominal distention, and weight loss.
- CT enterography revealed dilated small bowel loops without obstruction; capsule endoscopy showed delayed transit.
- Duodenal histology confirmed Marsh 3a villous atrophy.
Findings:
- Giardia lamblia trophozoites were identified in stool and duodenal biopsies.
- The patient's symptoms resolved rapidly following metronidazole treatment.
Implications:
- Giardia lamblia should be considered in the differential diagnosis of intestinal pseudo-obstruction and villous atrophy.
- Effective treatment of Giardia lamblia can lead to complete clinical and histological recovery.
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