Procainamide-induced pseudo-obstruction in a diabetic patient

We report the case of a 65-year-old black man who presented to our facility with pseudo-obstruction of the bowel within two weeks of the initiation of oral sustained-release procainamide hydrochloride therapy. The syndrome continued despite conversion to intravenous procainamide and only resolved after discontinuation of the medication. We believe that the anticholinergic properties of procainamide, coupled with the patient's diabetes, contributed to severe hypomotility of the gastrointestinal tract and, subsequently, a pseudo-obstructive state. The syndrome of drug-induced pseudo-obstruction is also reviewed.