Elevated Prostaglandin E in Idiopathic Intestinal Pseudo-Obstruction

The syndrome of idiopathic intestinal pseudoobstruction, described by Naish et al. in 1960,¹ consists of repeated bouts of idiopathic intestinal pseudo-obstruction accompanied by diarrhea and at times steatorrhea. Despite clinical and radiographic evidence of mechanical obstruction of the intestine, no physical blockage of the lumen can be demonstrated. Moreover, no toxic, neurologic, endocrinologic or metabolic cause for this disorder has ever been documented. Prostaglandins have been implicated in the pathogenesis of other diarrhea syndromes, including cholera, carcinoid² and the diarrhea associated with medullary carcinoma of the thyroid.³ In the patient described below, with watery diarrhea, intestinal pseudo-obstruction and abnormal platelet.