Recurrent Intestinal Obstruction Revealing Hypothyroidism

Introduction: Intestinal obstruction/pseudo-obstruction remains an unusual and often unrecognized clinical presentation of hypothyroidism, particularly in the inaugural forms. This explains significant diagnostic delay and unnecessary surgical interventions often noted in these cases.
We report here an original observation of recurrent intestinal obstruction revealing hypothyroidism.

Case Report: 53-years-old patient was explored in emergency and surgery departments for acute abdominal pain with constipation, and vomits. The diagnosis of intestinal occlusion with negative investigations and spontaneous resolution was retained.

He was readmitted twice for the same symptomatology. During his third admission, he was referred for an internist opinion, and the thyroid tests confirmed the diagnosis of a deep hypothyroidism with TSH at 68 μIU/ml and fT4 at 2 pmol/l. Under hormone replacement therapy, the evolution was favorable with disappearance of digestive symptomatology and no other occlusive episode has been reported for five years now.

Conclusion: As rare as it may be, intestinal obstruction/pseudo-obstruction caused by hypothyroidism, deserves to be known to avoid unnecessary, and sometimes heavy, surgery. Our observation is characterized by its recurrent and revealing character of the disease.

Keywords: Intestinal obstruction, pseudo-obstruction, hypothyroidism, acute abdomen.