1992
DOI: 10.1002/bjs.1800790203
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Acute colonic pseudo-obstruction

Abstract: The syndrome of acute colonic pseudo-obstruction is well delineated but its aetiology remains poorly understood and patients are still treated inappropriately. This article reviews the pathogenesis and surgical management of this condition. Early diagnosis is stressed as a pivotal factor in reducing morbidity and mortality.

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Cited by 85 publications
(52 citation statements)
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References 72 publications
(1 reference statement)
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“…The mechanisms through which these different conditions temporarily suppress colonic motility and induce dilation are unknown. The parasympathetic nervous system increases contractility, whereas the sympathetic nerves decrease motility [3]. An imbalance in autonomic innervation, produced by a variety of factors, leads to excessive parasympathetic suppression or sympathetic stimulation.…”
Section: Pathophysiologymentioning
confidence: 99%
See 1 more Smart Citation
“…The mechanisms through which these different conditions temporarily suppress colonic motility and induce dilation are unknown. The parasympathetic nervous system increases contractility, whereas the sympathetic nerves decrease motility [3]. An imbalance in autonomic innervation, produced by a variety of factors, leads to excessive parasympathetic suppression or sympathetic stimulation.…”
Section: Pathophysiologymentioning
confidence: 99%
“…The pathogenesis of ACPO is not completely understood, although it likely results from an alteration in the autonomic regulation of colonic motor function [3]. The vast majority of patients with ACPO have the syndrome in association with a wide array of clinical conditions.…”
Section: Pathophysiologymentioning
confidence: 99%
“…A pharmacological approach using intravenous administration of neostigmine, an acetylcholinesterase inhibitor, has recently been proposed by Ponec et al [7]. This is based on the theory that colonic pseudo-obstruction is caused by excessive sympathetic stimulation, parasympathetic dysfunction, or both [6,18,19]. The drug was administered to patients with pseudo-obstruction of various origins who had shown no response after 24 h of conservative therapy and led to a rapid decompression of the colon in the majority of cases [7].…”
Section: Discussionmentioning
confidence: 99%
“…• Exploratory laparotomy is indicated in patients with massive cecal distention presenting with pneumoperitoneum, development of peritonitis, respiratory failure, and diagnostic uncertainty. Reported overall mortality rate of surgical procedures in patients with acute colonic pseudo-obstruction is as high as 10% to 15% [42][43][44][45].…”
Section: Surgical Cecostomymentioning
confidence: 99%