Table 1 Open in new tab Comparison of...

Age

Sex

Symptoms

Physical examination

Investigation

Imaging

Diagnosis

Anti-malarial drug

Response

Reference number

One and half year

Female

fever, vomiting and abdominal distension

Hepatomegaly

ICT

AXR and Abd US: were normal

Functional bowel obstruction due to malaria

42 years

Male

Fever, abdominal pain colicky in character, progressive abdominal distension, inability to pass stool and flatus over 4 days, no vomiting.

Mildly distended abdomen with mild diffuse tenderness.
Tympanic abdomen
with exaggerated bowel sounds.

ICT

AXR: Increased bowel gas.
Abd US: Mild free intra-abdominal fluid in all four quadrants.

Functional bowel obstruction due to malaria

I.V. Quinine infusion

Faeces passed 48 hours after initiation of Quinine. Complete resolution of abdominal pain, distension on the fourth day.

32 years

Male

constipation and abdominal pain

Spleen was palpable 3 finger breadth below the coastal margin

Mechanical bowel obstruction caused by massive splenomegaly due to malaria

Atebrin and plasmoquine, followed by quinine.

42 years

Male,
American

Functional bowel obstruction due to malaria

28 years

Male

Abdominal pain, inability to pass stool and flatus. Intermittent fever for 4 days, myalgia and back pain and sometimes vomiting.

The abdomen was moderately distended with mild tenderness.
Percussion note: tympanic
Auscultation: exaggerated bowel sounds.

Blood film for malaria

AXR: Distended bowel with gas with no significant air-fluid levels.
Abd US: Loops of distended bowel with mild free intra-abdominal fluid in all four quadrants.

Functional bowel obstruction due to malaria

I.V. artesunate

He passed flatus about 36 hours after starting the I.V. artesunate and he passed faeces after 48 hours with the resolution of the abdominal pain and distension.

Table 1

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Comparison of the reported cases of bowel obstruction due to malaria

	Age	Sex	Symptoms	Physical examination	Investigation	Imaging	Diagnosis	Anti-malarial drug	Response	Reference number
1	One and half year	Female	fever, vomiting and abdominal distension	Hepatomegaly	ICT	AXR and Abd US: were normal	Functional bowel obstruction due to malaria	-	-	4
2	42 years	Male	Fever, abdominal pain colicky in character, progressive abdominal distension, inability to pass stool and flatus over 4 days, no vomiting.	Mildly distended abdomen with mild diffuse tenderness. Tympanic abdomen with exaggerated bowel sounds.	ICT	AXR: Increased bowel gas. Abd US: Mild free intra-abdominal fluid in all four quadrants.	Functional bowel obstruction due to malaria	I.V. Quinine infusion	Faeces passed 48 hours after initiation of Quinine. Complete resolution of abdominal pain, distension on the fourth day.	1
3	32 years	Male	constipation and abdominal pain	Spleen was palpable 3 finger breadth below the coastal margin	-	-	Mechanical bowel obstruction caused by massive splenomegaly due to malaria	Atebrin and plasmoquine, followed by quinine.	-	5
4	42 years	Male, American	-	-	-	-	Functional bowel obstruction due to malaria	-	-	1
5	28 years	Male	Abdominal pain, inability to pass stool and flatus. Intermittent fever for 4 days, myalgia and back pain and sometimes vomiting.	The abdomen was moderately distended with mild tenderness. Percussion note: tympanic Auscultation: exaggerated bowel sounds.	Blood film for malaria	AXR: Distended bowel with gas with no significant air-fluid levels. Abd US: Loops of distended bowel with mild free intra-abdominal fluid in all four quadrants.	Functional bowel obstruction due to malaria	I.V. artesunate	He passed flatus about 36 hours after starting the I.V. artesunate and he passed faeces after 48 hours with the resolution of the abdominal pain and distension.

	Age	Sex	Symptoms	Physical examination	Investigation	Imaging	Diagnosis	Anti-malarial drug	Response	Reference number
1	One and half year	Female	fever, vomiting and abdominal distension	Hepatomegaly	ICT	AXR and Abd US: were normal	Functional bowel obstruction due to malaria	-	-	4
2	42 years	Male	Fever, abdominal pain colicky in character, progressive abdominal distension, inability to pass stool and flatus over 4 days, no vomiting.	Mildly distended abdomen with mild diffuse tenderness. Tympanic abdomen with exaggerated bowel sounds.	ICT	AXR: Increased bowel gas. Abd US: Mild free intra-abdominal fluid in all four quadrants.	Functional bowel obstruction due to malaria	I.V. Quinine infusion	Faeces passed 48 hours after initiation of Quinine. Complete resolution of abdominal pain, distension on the fourth day.	1
3	32 years	Male	constipation and abdominal pain	Spleen was palpable 3 finger breadth below the coastal margin	-	-	Mechanical bowel obstruction caused by massive splenomegaly due to malaria	Atebrin and plasmoquine, followed by quinine.	-	5
4	42 years	Male, American	-	-	-	-	Functional bowel obstruction due to malaria	-	-	1
5	28 years	Male	Abdominal pain, inability to pass stool and flatus. Intermittent fever for 4 days, myalgia and back pain and sometimes vomiting.	The abdomen was moderately distended with mild tenderness. Percussion note: tympanic Auscultation: exaggerated bowel sounds.	Blood film for malaria	AXR: Distended bowel with gas with no significant air-fluid levels. Abd US: Loops of distended bowel with mild free intra-abdominal fluid in all four quadrants.	Functional bowel obstruction due to malaria	I.V. artesunate	He passed flatus about 36 hours after starting the I.V. artesunate and he passed faeces after 48 hours with the resolution of the abdominal pain and distension.

ICT, Immunochromatographic test; AXR, Abdominal X-ray; Abd US, Abdominal Ultrasonography; I.V, Intravenous.

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