Acute colonic pseudo-obstruction

Saunders, Michael D.

doi:10.1016/j.bpg.2007.03.001

Cited by 97 publications

(59 citation statements)

References 45 publications

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“…The pathophysiology of acute colonic pseudo‐obstruction is obscure. A variety of hypotheses relating to ‘imbalanced’ extrinsic autonomic innervation prevails in the review literature11, 18, 21–23. Although these are credible on the basis of association with prevertebral and retroperitoneal trauma or disease1, 7, 21, 24, and responses to pharmacological therapy, there is no direct evidence in their support.…”

Section: Aetiologymentioning

confidence: 99%

Acute colonic pseudo-obstruction

Giorgio

Knowles

2009

British Journal of Surgery

167

107

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Section: Aetiologymentioning

confidence: 99%

Acute colonic pseudo-obstruction

Giorgio

Knowles

2009

British Journal of Surgery

167

107

View full text Add to dashboard Cite

show abstract

“…Important predisposing factors for the development of ACPO include trauma, infections, and cardiac disease as well as underlying medical illnesses such as cancer. If left untreated, ACPO may lead to intestinal perforation in 3-15% of cases, with an estimated mortality rate of 50% once spontaneous perforation occurs [1]. …”

Section: Introductionmentioning

confidence: 99%

Neostigmine for the treatment of acute colonic pseudo-obstruction (ACPO) in pediatric hematologic malignancies

et al. 2010

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BackgroundAcute colonic pseudo-obstruction (ACPO) refers to dilatation of the colon and decreased bowel motility without evidence of mechanical obstruction. Neostigmine, an acetylcholinesterase inhibitor, has been used in patients in whom supportive therapy failed to resolve ACPO. Here, we report the results of administering neostigmine to treat ACPO in children with hematologic malignancies.MethodsBetween September 2005 and December 2009, 10 patients (8 male and 2 female) were diagnosed with ACPO at the Department of Pediatrics, Catholic University of Korea. Diagnosis of ACPO was based on typical clinical features as well as colonic dilatation found on abdominal CT imaging. Neostigmine was administered subcutaneously at a dosage of 0.01 mg/kg/dose (maximum 0.5 mg) twice daily for a maximum of 5 total doses. ACPO was determined to be responsive to neostigmine if the patient showed both stool passage and improvement of clinical symptoms.ResultsThe study group included 8 acute lymphoblastic leukemia patients, 1 patient with malignant lymphoma, and 1 patient with juvenile myelomonocytic leukemia. The median age at ACPO diagnosis was 8.5 years (range, 3-14). Overall, 8 patients (80%) showed therapeutic response to neostigmine at a median of 29 hours after the initial administration (range, 1-70). Two patients (20%) showed side effects of grade 2 or above, but none complained of cardiovascular symptoms that required treatment.ConclusionIn this study, ACPO was diagnosed most often in late-childhood ALL patients. Subcutaneous neostigmine can be used to effectively treat ACPO diagnosed in children with hematologic malignancies without major cardiovascular complications.

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“…This approach has been reported to be successful in approximately 80% of patients, but up to 20% will require repeat endoscopy due to recurrence [7]. If perforation occurs, the mortality rate is as high as 50% [8], and surgical management is mandatory.…”

Section: Discussionmentioning

confidence: 99%

Nonocclusive Mesenteric Ischemia Associated with Ogilvie Syndrome

Sakamoto¹,

Suganuma

Okada

et al. 2014

Case Reports in Surgery

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Nonocclusive mesenteric ischemia (NOMI) is one type of acute mesenteric ischemia. Colonic pseudoobstruction, known as Ogilvie syndrome, is a disorder defined by colonic distension in the absence of mechanical obstruction. A relationship between these diseases has not yet been reported, based on a review of the literature. We report a patient with NOMI secondary to Ogilvie syndrome. An 82-year-old woman reported three days of intermittent abdominal pain. Plain computed tomography scan showed colonic obstruction at the rectosigmoid colon. Colonoscopy was performed that showed a large amount of stool and no evidence of tumor or other physical causes of obstruction. We diagnosed the patient with Ogilvie syndrome and continued nonoperative management. On the third hospital day, she complained of abdominal distension. A repeat CT scan showed pneumatosis intestinalis in the small bowel and ascending colon, with portal venous gas. Emergency laparotomy was performed with diagnosis of mesenteric ischemia. Intraoperatively, there were multiple skip ischemic lesions in the small intestine and cecum. We resected the ischemic bowel and performed a distal jejunostomy. Her residual small bowel measured just 20 cm in length. Postoperatively, her general status gradually improved. She was discharged with total parenteral nutrition and a small amount of enteral nutrition.

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Acute colonic pseudo-obstruction

Cited by 97 publications

References 45 publications

Acute colonic pseudo-obstruction

Acute colonic pseudo-obstruction

Neostigmine for the treatment of acute colonic pseudo-obstruction (ACPO) in pediatric hematologic malignancies

Nonocclusive Mesenteric Ischemia Associated with Ogilvie Syndrome

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