Acute Colonic Pseudo-Obstruction.

Area of Science:

• Gastroenterology
• Surgical Emergencies
• Colorectal Surgery

Background:

• Acute colonic pseudo-obstruction (ACPO) is a functional disorder characterized by colonic dysmotility and distension without mechanical obstruction.
• The precise pathophysiology of ACPO is not fully understood despite advancements in motility research.
• Current management strategies for ACPO have seen limited changes over the past four decades.

Purpose of the Study:

• To provide a concise update on the causes, diagnosis, and management of acute colonic pseudo-obstruction.
• To highlight current treatment approaches for ACPO, including conservative and interventional methods.
• To discuss considerations for patients with recurrent ACPO and potential underlying functional disorders.

Main Methods:

• Review of existing literature on acute colonic pseudo-obstruction.
• Analysis of diagnostic criteria and current management protocols for ACPO.
• Discussion of surgical and non-surgical interventions for ACPO.

Main Results:

• ACPO management involves operative intervention for perforation/ischemia, conservative care for others, and decompression (neostigmine or colonoscopy) for refractory cases.
• Recurrent ACPO may indicate underlying functional disorders like slow-transit dysmotility or chronic intestinal pseudo-obstruction.
• Despite technological advances, ACPO pathophysiology remains unclear.

Conclusions:

• ACPO is an emergency surgical condition requiring timely diagnosis and management.
• Conservative management and decompression are primary strategies, with consideration for underlying motility disorders in complex cases.
• Further research into ACPO pathophysiology is needed to refine treatment approaches.