Cisapride as a successful treatment for acute intestinal pseudo-obstruction

Cisapride has been used in the treatment of chronic intestinal pseudo-obstruction with some success; however, the use of cisapride in the treatment of acute pseudo-obstruction has not been adequately studied. We describe a case of acute intestinal pseudo-obstruction successfully treated with cisapride. To our knowledge, this is the second such case reported in the English language literature. Our patient's acute intestinal pseudo-obstruction was probably precipitated by pneumonia and sepsis, and the prompt resolution of his intestinal pseudo-obstruction after initiation of cisapride therapy (despite progressive deterioration of his overall clinical status) implicates cisapride as the cause of the improved intestinal function. Therefore, we suggest that a trial of cisapride be considered for patients with acute intestinal pseudo-obstruction when other therapeutic maneuvers have failed.