Pseudo-obstruction associated with colonic ischemia: successful management with colonoscopic decompression

Colonic pseudo-obstruction has been associated with colonic ischemia in only 7-10% of cases. When both conditions are present, most authors recommend immediate laparotomy because of the additional weakening of the bowel wall induced by the presence of ischemia and the resultant increased risk of perforation. We report on three patients with pseudo-obstruction and right-sided colonic ischemia who were successfully managed with colonoscopic decompression with tube placement. Surgery may not be required in patients with pseudo-obstruction and associated colonic ischemia.