Intestinal pseudo-obstruction is a massive colonic dilation with signs and symptoms of colonic obstruction, but without a mechanical cause. A 49-year-old female patient complained of nausea, vomiting, and abdominal distension 1 month after a massive brainstem hemorrhage. No improvement was seen with conservative treatments. An extended-length rectal tube was inserted to perform glycerin enema. In addition, bethanechol (35 mg per day) was administered to stimulate colonic motility. The patient's condition gradually improved over a 2-month period without any surgical intervention. Extended length rectal tube enema and bethanechol can be used to improve intestinal pseudo-obstruction in stroke patients.
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To perform nerve conduction studies of the four branches of the superficial peroneal nerves to determine normal values and anatomic variations in Koreans.
Antidromic sensory nerve conduction studies of the four distal branches were performed on 70 healthy subjects (100 feet). We applied electrical stimulation at the midpoint of medial and lateral malleoli for the medial dorsal cutaneous nerve (MDCN), and at the lateral 1/4 point between the medial and lateral malleoli for the 2 branches of the intermediate dorsal cutaneous nerve (IDCN).
Reference values (mean±SD) of the onset/ peak latency (ms)/ sensory action potential amplitude (µV) for the two branches of the MDCN and for the first branch of the IDCN were 2.2±0.3/2.9±0.3/9.2±3.1, 2.2±0.3/2.8±0.3/9.1±3.0 and 2.3±0.4/2.9±0.3/8.5±2.8, respectively. For the second IDCN branch, the reference values were 2.3±0.4/3.0±0.4/7.1±2.6 but anomalous sural innervation was also found. Three types of IDCN innervations to the fourth interdigital web space were detected. In type I, the fourth interdigital webspace was innervated solely by the IDCN, whereas in type II, it was innervated by both the IDCN and distal sural nerve. In type III, it was solely innervated by the distal sural nerve.
The results of this study show the reference values of the distal sensory branches of the superficial peroneal nerve, and provide information on the variant innervations to the fourth interdigital web space.
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