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Malaysian Journal of Medical Sciences
School of Medical Sciences, Universiti Sains Malaysia
ISSN: 1394-195X
Vol. 23, No. 6, 2016, pp. 123-127
Bioline Code: mj16087
Full paper language: English
Document type: Case Report
Document available free of charge

Malaysian Journal of Medical Sciences, Vol. 23, No. 6, 2016, pp. 123-127

 en Recurrent Intestinal Obstruction in a Patient with Selective IgA Deficiency
Hui, Chee-Kin


A 32 year old woman presented with acute onset of abdominal pain and fever. An urgent computerised tomography (CT) of the whole abdomen showed dilated loop at the terminal ileum in the right lower abdomen with thickening of the wall and oedema. The CT was suggestive of distal small bowel obstruction at the ileum with surrounding wall oedema. Multiple biopsies taken from the terminal ileum and colon on colonoscopy were all unremarkable. She represented one-year later with a recurrence of intestinal obstruction. CT enteroclysis showed collapse at the distal 3 cm segment of the terminal ileum. There was no associated wall thickening, active inflammatory changes or ileitis. This was suspicious of post-inflammatory change or fibrosis. She was subsequently found to have selective IgA deficiency with recurrent infection in the terminal ileum resulting in intestinal obstruction. In conclusion, selective IgA deficiency should be considered in patients with recurrent intestinal obstruction without anatomical obstructions.

selective IgA deficiency; intestinal obstruction; antibiotic prophylaxis

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