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Changes in colorectal function in patients with chronic colonic pseudoobstruction
V A Loening-Baucke1, S Anuras, F A Mitros
1Department of Pediatrics and Pathology, University of Iowa, Iowa City 52242.
Digestive Diseases and Sciences
|October 1, 1987
Summary
Chronic colonic pseudoobstruction involves severe bowel distension. Subtotal colectomy provided relief for most primary cases, suggesting potential myogenic abnormalities.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Physiology
Background:
- Chronic colonic pseudoobstruction (CCPO) is a rare condition causing severe bowel distension.
- It can be primary or secondary to underlying diseases.
- Diagnosis and treatment remain challenging.
Purpose of the Study:
- To investigate the pathophysiology of isolated chronic colonic pseudoobstruction.
- To evaluate diagnostic methods and treatment outcomes.
Main Methods:
- Eleven patients with CCPO underwent lower bowel motility studies, radiology, and rectal biopsies.
- Colonic transmural sections were analyzed for neural and muscular defects.
Main Results:
- All patients exhibited massive gaseous colonic distension on plain abdominal x-rays.
- Decreased lower bowel motility and increased rectal wall elasticity were observed.
- Myogenic abnormalities were suggested, but no specific morphologic defects were identified except in Hirschsprung's disease.
- Five of seven primary CCPO patients achieved relief after subtotal colectomy and ileoproctostomy.
Conclusions:
- CCPO may involve myogenic abnormalities of the sigmoid or rectal wall.
- Subtotal colectomy and ileoproctostomy can be effective for primary CCPO.
- Further research into the underlying mechanisms is warranted.
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