Acute colonic pseudo-obstruction associated with abdominal paracentesis

Area of Science:

• Gastroenterology
• Hepatology
• Colorectal Surgery

Background:

• Ascites is a common complication of alcoholic liver disease.
• Alcoholic liver disease can lead to significant morbidity and mortality.
• Acute colonic pseudo-obstruction (ACPO) is a rare condition mimicking bowel obstruction.

Observation:

• A 61-year-old male with alcoholic liver disease presented with ascites.
• An ascites drain was placed for fluid management.
• 24 hours post-procedure, the patient developed symptoms consistent with ACPO.

Findings:

• This case represents the first reported instance of ACPO secondary to abdominal paracentesis.
• ACPO is typically associated with major surgery or severe sepsis.
• The patient's ACPO resolved with conservative management, including nasogastric decompression and bowel rest.

Implications:

• Abdominal paracentesis, while generally safe, may precipitate ACPO in susceptible individuals.
• Clinicians should be aware of ACPO as a potential complication of ascites drainage.
• Conservative management appears effective for ACPO following paracentesis, potentially avoiding surgery or endoscopy.