Enteric neuropathy - when a surgeon is not immediately needed

Peripheral neuropathies with involvement of the autonomic nervous system are a recognized cause of gastrointestinal dysmotility. We describe a patient with chronic intestinal pseudo-obstruction (CIPO) in the course of chronic inflammatory demyelinating neuropathy and a complicated diagnostic procedure. Diagnostics and therapy of CIPO continue to pose a significant challenge for clinicians. The disease should be considered in patients presenting with clinical features of intestinal obstruction without radiological evidence of a mechanical obstacle. In these patients, the diagnosis is usually confirmed by histological examination of a full-thickness intestinal biopsy. However, the high rate of misdiagnosis means that CIPO patients may not be treated properly and may undergo unnecessary abdominal surgery.