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Unexplained gastrointestinal dysmotility: the clue may lie in the brain
  1. Adrian Parry-Jones1,
  2. Peter Paine2,
  3. Ranjit Ramdass3,
  4. Neal Townsend4,
  5. Richard Hammonds5,
  6. Antje Teubner6,
  7. Jon Shaffer6,
  8. Paul Cooper1,
  9. Simon Lal6
  1. 1Department of Neurology, Salford Royal Hospital, Salford, UK
  2. 2Department of Gastroenterology, Salford Royal Hospital, Salford, UK
  3. 3Department of Neurophysiology, Salford Royal Hospital, Salford, UK
  4. 4Department of Radiology, Salford Royal Hospital, Salford, UK
  5. 5Department of Gastroenterology, North Manchester General Hospital, Manchester, UK
  6. 6Intestinal Failure Unit, Salford Royal Hospital, Salford, UK
  1. Correspondence to Dr Adrian Parry-Jones, Brain Injury Research Group, Clinical Sciences Building, Salford Royal Hopsital, Stott Lane, Salford M6 8HD, UK; adrian.parry-jones{at}manchester.ac.uk

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Clinical presentation

A 23-year-old male was referred to our tertiary intestinal failure unit for evaluation and nutritional support. He had presented to a neighbouring hospital with a 2 year history of episodic vomiting, abdominal pain and progressive weight loss. Evaluation at that hospital had suggested an annular pancreas causing duodenal narrowing, and he underwent a surgical resection and gastrojejunostomy. Symptoms persisted for >3 months postsurgery and a working diagnosis of severe gastrointestinal dysmotility was made following further endoscopic and radiological investigation (figure 1). Following further nutritional decline, parenteral nutrition was commenced and he was referred to our hospital for …

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