Guillain-Barré syndrome presenting with abdominal pain as the initial manifestation: a case report

Background Guillain-Barré syndrome (GBS) is an acute immune-mediated polyneuropathy, characteristically presenting with ascending limb weakness and sensory disturbances. However, GBS presenting with abdominal pain as the initial manifestation is relatively rare, abdominal pain is not a characteristic manifestation, its occurrence may delay diagnosis of GBS. Case presentation A 62-year-old male patient presented to our hospital in January 2024 with a 5-day history of abdominal pain in the right upper quadrant. He was initially diagnosed with acute cholecystitis. However, the patient subsequently developed progressive limb weakness and loss of tendon reflexes, along with worsening respiratory distress and chest tightness, ultimately leading to a diagnosis of GBS. This case report describes a severe case of GBS presenting with acute abdominal pain as the initial manifestation, highlighting the diagnostic challenges of GBS in the setting of acute abdominal pain. Conclusion Abdominal pain may precede characteristic neurological symptoms in GBS. GBS presenting with acute abdominal pain as the initial manifestation may pose diagnostic challenges and lead to delayed diagnosis. Physicians should maintain a high index of suspicion for GBS in patients with abdominal pain and rapid neurological deterioration.