Abdominal distension and vomiting in a lupus patient with a desire for pregnancy: think beyond the baby!

Intestinal pseudo-obstruction (IPO) is a rare enteric motility disorder with clinical features of intestinal obstruction in the absence of mechanical blockage. IPO usually presents as recurrent, self-limiting episodes of abdominal distension, postprandial pain, nausea and vomiting. Over time, symptoms can persist, leading to gut stasis with bacterial overgrowth, malabsorption and malnutrition. We present a case of IPO related to systemic lupus erythematosus, treated with intravenous pulses of high-dose methylprednisolone. Nutritional testing should be provided as insidious progression to intestinal failure may go undetected at an early stage, especially in situations with increased nutritional requirements, like pregnancy