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Radiographic changes after colonoscopic decompression for acute pseudo-obstruction.

T N Pham1, B C Cosman, P Chu

  • 1Department of Surgery, San Diego Veterans Affairs Healthcare System and University of California, USA.

Diseases of the Colon and Rectum
|December 29, 1999
PubMed
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Colonoscopic decompression offers minimal immediate reduction in cecal diameter for acute colonic pseudo-obstruction (Ogilvie's syndrome). Cecal and transverse colon dilation patterns are closely correlated, suggesting shared pathophysiology.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Background:

  • Acute colonic pseudo-obstruction, or Ogilvie's syndrome, is a condition characterized by colonic dilation without mechanical obstruction.
  • Colonoscopy is a primary intervention for managing this condition, aiming to decompress the colon.

Purpose of the Study:

  • To assess the immediate impact of colonoscopic decompression on cecal diameter in patients with Ogilvie's syndrome.
  • To investigate correlations between the diameters of dilated segments of the colon following decompression.

Main Methods:

  • Retrospective review of 24 patients undergoing colonoscopic decompression for acute colonic pseudo-obstruction.
  • Measurement of cecal, transverse, descending, and sigmoid colon diameters on serial radiographs.

Main Results:

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  • Colonoscopic decompression resulted in a modest decrease in mean cecal diameter (-2 cm at 4 hours, -2.2 cm at 1 day).
  • A significant correlation was observed between cecal and transverse colon diameters post-decompression (P<0.05).
  • No significant correlation was found between cecal diameter and descending or sigmoid colon diameters.

Conclusions:

  • Colonoscopic decompression provides limited immediate reduction in cecal size for acute colonic pseudo-obstruction.
  • The correlated dilation patterns of the cecum and transverse colon support the hypothesis of a common underlying pathophysiology affecting these segments.