Reactions 1704, p241 - 2 Jun 2018 Various toxicities: case report A 32-year-old woman developed narcotic bowel syndrome, acute bowel obstruction, intussusception and acute bowel necrosis during treatment with methadone for severe, unexplained and intermittent abdominal pain [route, dosage, duration of treatment to reactions onsets and outcomes not stated]. The woman presented with nausea and worsening abdominal pain. She had a six month history of severe, unexplained and intermittent abdominal pain. Her medical history was significant for chronic opiate dependence [specific drug not stated]. Currently, she had been receiving methadone for severe, unexplained and intermittent abdominal pain. She had undergone laparoscopic Roux-en-Y gastric bypass weight loss operation twelve years ago and a laparoscopic reduction of an intussusception two years ago at an outside hospital. On examination, she was tachycardic and afebrile. An abdominal examination demonstrated palpable and distended large mass in the right upper quadrant with moderate tenderness, worse on the right side. The woman was taken emergently to the operating room for an exploratory mid-line laparotomy. Operative findings showed a small bowel intussusception, which obstructed the jejunoje-junostomy. The intussusceptum segment was 160cm in length. Manual reduction showed that the entire intussusceptum segment was necrotic and required excision. The resected bowel pathology showed negative results for neoplasm. Author comment: "Bowel dysmotility is a known complication of chronic opiate use and may predispose to intussusception." "Narcotic Bowel Syndrome, a subset of opioid induced bowel dysfunction". "In looking back, her ongoing opioid use and likely Narcotic Bowel Syndrome may have predisposed her to bowel dysmotility and therefore increased her risk for recurrent mild intussusception which ultimately incarcerated leading to acute bowel necrosis." Rosen P, et al. Opioids and intussusception: A case report of mega intussusception (160 cm) twelve years after a laparoscopic Roux-en-Y gastric bypass in a methadone user. Diseases of the Colon and Rectum 61: e123, No. 5, May 2018. Available from: URL: http://doi.org/10.1097/DCR.0000000000001104 [abstract] - USA 803323343 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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