Intestinal pseudo-obstruction (IPO) either acute or chronic is a condition including features of intestinal ileus in absence of mechanical obstruction.Our paper presents such a rare case of idiopathic IPO in a 53-year-old male patient with recurrent episodes of pseudo-obstruction,whicb were successfully resolved by anticholinesterase agents,motilin agonists or colonic decompression.However,the patient finally underwent total colectomy.Huge colonic dilatation was identified intraoperatorily,while histology showed a neuropathic variant of chronic intestinal pseudo-obstruction.Etiologic mechanisms and current therapeutic methods are reviewed in this paper,which concludes that IPO is a condition in which conservative treatment usually fails.Total colectomy with ileoanal pouch may be the only solution in these situations.