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acute colonic pseudo-obstruction: A systematic review of aetiology and mechanisms

World Journal of Gastroenterology 2017年第30期23卷 5634-5644页

作者： Cameron I Wells Gregory O’Grady Ian P Bissett Department of Surgery University of Auckland Department of Surgery Auckland District Health Board

To critically review the literature addressing the definition, epidemiology, aetiology and pathophysiology of acute colonic pseudo-obstruction (ACPO). METHODSA systematic search was performed to identify articles investigating the aetiology and pathophysiology of ACPO. A narrative synthesis of the evidence was undertaken. RESULTSNo consistent approach to the definition or reporting of ACPO has been developed, which has led to overlapping investigation with other conditions. A vast array of risk factors has been identified, supporting a multifactorial aetiology. The pathophysiological mechanisms remain unclear, but are likely related to altered autonomic regulation of colonic motility, in the setting of other predisposing factors. CONCLUSIONFuture research should aim to establish a clear and consistent definition of ACPO, and elucidate the pathophysiological mechanisms leading to altered colonic function. An improved understanding of the aetiology of ACPO may facilitate the development of targeted strategies for its prevention and treatment.

关键词： acute colonic pseudoobstruction acute colonic pseudo-obstruction colonic Intestinal pseudo obstruction Ogilvie’s syndrome pseudo-obstruction pseudo-obstruction

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acute colonic pseudo-obstruction (ACPO): An Expanding Colon with Unusual Risk Factors

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Open Journal of Internal Medicine 2024年第2期14卷 167-174页

作者： Kelly Schulte Alyson Terry Grace Boyle Dmitriy Scherbak HCA Healthone Sky Ridge Medical Center Lone Tree Colorado USA

The distention of the colon without mechanical or anatomical obstruction, acute colonic pseudo-obstruction (ACPO), is a common condition occurring in the critically ill. ACPO in the setting of an acute pulmonary embolism and embolic stroke is a rarity. A 76-year-old female with shortness of breath, left hemiparesis and right-sided paresthesias presented with acute pulmonary embolism and acute infarcts of the left caudate nucleus, thalamus and occipital lobe. Her hospitalization was complicated with persistent distention of the large bowel without dilation of the small bowel. Empiric antibiotics were initiated without improvement and laboratory studies including Clostridium difficile were negative. She underwent nasogastric decompression and two decompressive colonoscopies with a resolution of her symptoms. This case illustrates an example of acute abdominal distension, without underlying etiology, in the setting of acute embolism of the pulmonary and cerebral vasculature. Early identification and action with decompressive colonoscopy were key to preventing further bowel damage or rupture.

关键词： acute colonic pseudo-obstruction ACPO Ogilvie’s Syndrome colonic Dilation acute Embolic Infarcts Cerebrovascular Accident Pulmonary Embolism PE

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Treatment of pediatric Ogilvie’s syndrome with low-dose erythromycin:A case report

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World Journal of Gastroenterology 2007年第13期13卷 2002-2003页

作者： Da-Peng Jiang Zhao-Zhu Li Sheng-Yang Guan Yu-Bo Zhang Department of Pediatric Surgery Second AffiliatedHospital of Harbin Medical University Harbin 150086Heilongjiang Province China

acute colonic pseudo-obstruction is a poorly understood syndrome, characterized by the signs, symptoms and radiological pattern of a large bowel obstruction without evidence for a mechanical obstruction. We report a case of a 2-year old boy who presented with progressive abdominal distention, vomiting and abdominal pain on postoperative d 3. Plain abdominal X-ray showed markedly dilated large bowel. Mechanical colonic obstruction was ruled out with hypaque enema. Ogilvie＇s syndrome was suspected. The patient received treatment with oral erythromycin which had an immediate beneficial effect. During the 6 mo follow-up, no recurrences of symptoms were observed. We provide a safe and effective therapy for Ogilvie＇s syndrome in pediatric individuals.

关键词： acute colonic pseudo-obstruction Erythromycin Abdominal distention Prokinetic agent

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