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[Pseudo-obstruction of the colon]
Zentralblatt Fur Chirurgie
|January 1, 1983
Summary
Pseudoobstruction of the colon mimics mechanical blockage without a physical cause, often linked to major system disorders. Diagnosis relies on imaging, with surgery indicated for persistent cases or complications like perforation.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Abdominal Imaging
Background:
- Pseudoobstruction of the colon presents as clinical and radiological signs of large intestine obstruction.
- No organic cause is identified in these cases.
Purpose of the Study:
- To review cases of pseudoobstruction of the colon.
- To discuss potential etiological factors and diagnostic/treatment strategies.
Main Methods:
- Review of 11 patient cases and 344 reported literature cases.
- Analysis of clinical and radiological findings.
- Discussion of diagnostic imaging (plain roentgenogram, barium enema) and treatment outcomes.
Main Results:
- 90% of patients had associated major system disorders, frequently pelvic.
- Imbalance in sympathetic-parasympathetic innervation is proposed as an etiological factor.
- Conservative treatment is effective within 72 hours for some cases.
Conclusions:
- Diagnosis relies on imaging; conservative management is first-line.
- Surgical decompression (cecostomy) is crucial for refractory cases.
- Immediate surgery is vital for cecal diameter >12 cm or perforation; resection for necrosis.