Acute Colonic Pseudo-Obstruction: A critical complication in burn patients

John, Albin; Anand, Rohan; Frost, Joshua; Griswold, John

doi:10.1016/j.burnso.2021.11.003

Cited by 3 publications

(5 citation statements)

References 18 publications

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“…Our approach to managing the patient was analogous in this regard, with discontinuation of any kind of intake, parenteral nutrition, adequate analgesia, and a well-defined antibiotic cover. Neostigmine is the drug of choice in limiting further colonic dysmotility and dilatation as it enhances the parasympathetic action of the autonomic nervous system on the gut [ 10 ]. Similarly, the patient in our case report was treated with neostigmine along with potassium supplements.…”

Section: Discussionmentioning

confidence: 99%

“…Bowel perforation is the most serious complication, and the risk increases substantially if the colon remains distended [ 10 ]. General guidelines indicate a cecal diameter >9cm to be abnormal and >12cm to be a strong risk of perforation.…”

Section: Discussionmentioning

confidence: 99%

“…General guidelines indicate a cecal diameter >9cm to be abnormal and >12cm to be a strong risk of perforation. The thin-walled cecum is the most common point of perforation [ 10 ]. In our case, the patient was discharged after the passage of stool and was closely followed up in outpatient for three months.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous Ogilvie's Syndrome in a Nonagenarian Male: A Study of a Rare Case With Literature Review

Hussain¹,

Waheed²,

Hamdullah³

et al. 2022

Cureus

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Ogilvie's syndrome, or acute colonic pseudo-obstruction (ACPO), is an occasional disorder that occurs in hospitalized patients who have undergone major surgery. It presents with the clinical features of intestinal obstruction without any definitive intrinsic or extrinsic anatomical cause. Without prompt treatment, it can lead to life-threatening complications. The risk factors of this syndrome must be sought to prevent its occurrence. We report a rare case of idiopathic, spontaneous, and non-traumatic Ogilvie's syndrome, with old age as the only present risk factor in our case. To our best knowledge, this is the first-ever case reported in English scientific literature from Pakistan.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Spontaneous Ogilvie's Syndrome in a Nonagenarian Male: A Study of a Rare Case With Literature Review

Hussain¹,

Waheed²,

Hamdullah³

et al. 2022

Cureus

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“…It is known from clinical observations that dysfunction of the distal GIT part in patients with burns manifests itself by pseudo-obstruction of the colon, sepsis and abdominal compartment syndrome, increase of colonic mucosa permeability, and bacterial translocation [1]. Late diagnosis, absence of objective data of the colon wall condition result in immediate surgical interventions [5]. More than 80% of the dead patients with extensive skin burns in the clinical picture were noted to have GIT dysfunction: diarrhea, constipation or nausea/vomiting, acute gastroduodenal ulcers, and bleeding [6].…”

Section: Introductionmentioning

confidence: 99%

“…The colon is an important anatomical part of the digestive tract determining the risk of developing severe complications in burned patients. The course of colon pseudo-obstruction (dynamic intestinal obstruction) in burned patients is aggressive and prognostically much more unfavorable than in patients of other nosological groups [5]. The functional condition of the colon, presence of dynamic obstruction or diarrhea strongly correlate with the risk of sepsis development in the burned people [7].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Skin Burn-Induced Colon Circulatory Disorders Using Optical Coherence Tomography Angiography and Laser Doppler Flowmetry (Experimental Study)

Ryabkov,

Peretyagin,

Shestakova

et al. 2024

Sovrem Tehnol Med

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The condition of gastrointestinal tract determines in many respects the regenerative capacity and the risk of complications in patients with extensive skin burns. However, the mechanism of developing vascular dysfunction in the colon in the burned individuals has so far been poorly studied.The aim of the investigation is to study intramural circulatory disorders of the colon using optical coherence tomography angiography (OCTA) and laser Doppler flowmetry (LDF) in different time periods after modeling a thermal burn.Materials and Methods. A deep thermal skin burn was induced on the area covering 10% of the body surface of Wistar rats (n=15). The blood flow of the colon wall was continuously monitored for 15 min before and 45 min after the burn using OCTA and LDF. The colon wall was again studied on days 7 and 14 using the same OCTA and LDF techniques. At each time point (45 min, day 7 and 14), 5 animals were withdrawn from the experiment, the colon wall was taken for histological study. The colon wall samples from three control rats without thermal skin burns were also histologically investigated.Results. During 45 min after the induction of the thermal burn, the in vivo OCTA and LDF techniques registered changes in intramural blood flow in the form of dropping of some arterioles and capillaries out of the general blood flow with concurrent activation of vascular shunts as a compensatory mechanism. Histologically, a marked edema of the submucosa, erythrocyte aggregation, and stasis in the capillary network were observed in this period. According to the OCTA and LDF data, the microcirculatory disorders in the colon were partially resolved by day 7, and by day 14 the analyzed indicators returned to the initial level. The data of the histological evaluation have shown that on day 7 after the burn induction, submucosal edema was absent, however, the signs of microcirculatory disorder and inflammatory changes remained. On day 14, the pathological changes in the tissues were not observed.Conclusion. The OCTA and LDF methods allowed us to establish experimentally that during the first 45 min thermal burn causes considerable disturbances of the blood flow in the colon wall, which normalizes only by day 14 if no therapy is administered. The obtained data on the mechanism of circulatory disorder development in the colon may become a basis for choosing therapy directed to prevention of intestine dysfunction in people with burns.

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Postburn Abdominal Pain of Gastrointestinal Origin: A Scoping Review

Soltany,

Hraib,

Apelian

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Summary: After burn injury, patients may have abdominal pain due to several causes and etiologies, some of which could be life-threatening, including pancreatitis, stress ulcers, Clostridium difficile infection, and so forth. This pain sometimes poses a major diagnostic challenge. This scoping review is the first reported review to address and discuss this entity of patients after burn injury in abdominal pain of gastrointestinal origin. A scoping review of PubMed, Google Scholar, and other electronic research sites was performed. All relevant articles of any study design were included in this review. Variables included in this study were sex distribution, age, related total burn surface area, incidence rate, characteristics of pain, diagnosis, management, outcomes, and mortality rate. The medical literature identified 114 articles. According to our inclusion criteria, 91 articles were reviewed in this article. Through these articles, we reviewed in detail the characteristics of postburn abdominal pain, the relevant diseases responsible for this complaint, the epidemiologic features of these diseases, and potential management approaches aiming to help burn specialists in making earlier diagnosis and, thus, timely treatment. Early recognition of postburn abdominal pain, as well as timely diagnosis and treatment, play a significant role in prognosis and mortality. Thus, it is extremely important for burn specialists and plastic surgeons to thoroughly investigate postburn abdominal pain. Also, one of the aims of this review was to shed light on the important role of the multidisciplinary team in burn patient management to improve the prognosis.

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Acute Colonic Pseudo-Obstruction: A critical complication in burn patients

Cited by 3 publications

References 18 publications

Spontaneous Ogilvie's Syndrome in a Nonagenarian Male: A Study of a Rare Case With Literature Review

Spontaneous Ogilvie's Syndrome in a Nonagenarian Male: A Study of a Rare Case With Literature Review

Diagnosis of Skin Burn-Induced Colon Circulatory Disorders Using Optical Coherence Tomography Angiography and Laser Doppler Flowmetry (Experimental Study)

Postburn Abdominal Pain of Gastrointestinal Origin: A Scoping Review

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