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[Colonic obstruction in Whipple's disease]
A Aloy Duch1, A Callejero Baguena, C Murcia Mesa
1Servicio de Medicina Interna, Hospital Sant Jaume, Calella, Barcelona.
Revista Espanola De Enfermedades Digestivas
|October 1, 1993
Summary
Whipple's disease can cause rare intestinal obstruction and bleeding due to enlarged lymph nodes. Ultrastructural analysis revealed intracellular bacilli, highlighting a previously undescribed complication.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pathology
Background:
- Whipple's disease is a rare systemic bacterial infection caused by Tropheryma whipplei.
- Gastrointestinal manifestations are common, but severe complications like intestinal obstruction are infrequent.
Observation:
- A patient presented with symptoms of low intestinal obstruction and gastrointestinal hemorrhage.
- Imaging and clinical evaluation suggested mesenteric retraction caused by enlarged intra-abdominal lymph nodes.
Findings:
- Ultrastructural examination of tissue samples confirmed the presence of abundant intracellular bacilli consistent with Tropheryma whipplei.
- The mesenteric retraction and subsequent obstruction/hemorrhage were directly attributed to the enlarged lymph nodes in this patient.
Implications:
- This case describes a novel and severe complication of Whipple's disease: intestinal obstruction and hemorrhage secondary to lymphadenopathy.
- Clinicians should consider Whipple's disease in the differential diagnosis for colonic obstruction, especially when accompanied by unexplained lymphadenopathy.