If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
A 20-year old man of Balkan descent presented to the emergency department with abdominal
pain and constipation of several days‘ duration. On clinical examination, he was afebrile
and normotensive. The abdomen was distended with reduced bowel sounds. Laboratory
investigations were significant for hyponatraemia (129 mmol/l) and elevated aminotransferases
in the double digits; inflammatory markers were normal. Abdominal ultrasound was unrevealing
as to a specific cause but meteorism was noted. Cortisol response to an adrenocorticotrophic
hormone stimulation test was normal. It transpired that the patient‘s father suffered
from an unusual disease involving the gastrointestinal tract, more specific details
could not be obtained at that time due to a language barrier. As symptoms worsened
over the next days, computed tomography (CT) of the abdomen was performed, demonstrating
marked and diffuse intestinal distension (Fig. 1A and B). A laboratory analysis revealed the cause.
Fig. 1CT scan of the abdomen (A, coronal and B, transverse plane) demonstrating marked intestinal
dilatation with air-fluid levels. No signs of mechanical obstruction are apparent.
