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Curious case of gut dysmotility
  1. Phey Shen Lee1,
  2. Laura Jopson1,
  3. Stephanie J Needham2,
  4. Christopher G Mountford1,
  5. Nick P Thompson1
  1. 1 Gastroenterology, Freeman Hospital, Newcastle upon Tyne, UK
  2. 2 Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  1. Correspondence to Dr Phey Shen Lee, Gastroenterology, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK; pheyshen.lee{at}

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A previously fit 78-year-old man presented with a 2-month history of dysphagia, epigastric pain, bloating, intermittent vomiting and 1½ stone weight loss. There was no history of new medications or recent travel abroad. Oesophagogastroduodenoscopy (OGD) showed a ‘cup and spill’ stomach with mild gastritis. Oesophageal biopsies were normal. CT scan of abdomen/pelvis showed extensive small bowel dilatation to the caecum but no transition point (figure 1A). Exploratory laparotomy revealed dilated small bowel loops without mechanical obstruction. Initial duodenal biopsies showed non-specific flattened villi with thickening and eosinophilia of submucosal vessels. Autoimmune screen including tissue transglutaminase and anti-neuronal antibodies were negative. The patient had normal renal and cardiac function.

Figure 1

(A) CT showing dilated, fluid-filled loops of small …

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  • Contributors PSL, LJ and NPT wrote the manuscript. SJN provided the histology images, description of the key features and expert advice. All authors critically appraised and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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