[Intestinal pseudo-obstruction in primary amyloidosis of the intestinal tract]

In an 80-year-old patient who had recurrent attacks of subileus over three years, a complete large bowel ileus finally developed. At laparotomy, massive dilatation and extreme fragility of the large bowel was found. Subtotal colectomy was performed, within 24 h of which the patient died. The surgical specimen and autopsy revealed primary amyloidosis (A light chain type) confined nearly exclusively to the intestinal tract. Pseudoobstructive ileus in amyloidosis can be chiefly accounted for by the heavy amyloid infiltration of the tunica muscularis of the bowel wall. Amyloidosis of the arteries and nerve plexus may be contributory factors.