Syndrome of Intestinal Pseudo-obstruction

Stephens, Frederick O.

doi:10.1136/bmj.1.5287.1248

Cited by 51 publications

(13 citation statements)

References 5 publications

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“…By contrast, the basic gross abnormality was a very dilated colon which was apparently unable to contract. It has been suggested that abnormalities of colonic motility can result from anoxia (Dudley et al, 1958), renal failure and electrolyte imbalance (Stephens, 1962), although the actual mode of action is uncertain.…”

Section: Causementioning

confidence: 98%

Pseudo-obstruction of the large bowel

1974

Journal of British Surgery

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SUMMARYTweloe episodes of large bowel pseudo-obstruction occurring in I 1 patients are described. The clinical and radiological features are discussed from a diagnostic aspect. The aetiology and treatment of the condition are considered.PSEUDO-OBSTRUCTION denotes apparent intestinal obstruction occurring in the absence of occlusion of the alimentary lumen. It may occur spontaneously, but frequently it is associated with pathology elsewhere in the body. The aetiology is uncertain and the condition presents problems in both diagnosis and management. This paper reports the author's personal experiences with 1 1 patients who presented with the large bowel syndrome in a period of 3+ years. Case reportsCase 1 : An 86-year-old man was admitted as an emergency on 23 February 1969. He lived alone and had been found collapsed and covered with vomit. He was dehydrated, confused and partially blind and had mild Parkinsonism. The abdomen was distended but not tender. Occasional bowel sounds were heard and the rectum was empty.His haemoglobin was 14.2 g/lOO ml. Abdominal X-rays showed many dilated loops of small bowel and a few fluid levels.An enema produced a moderate result. Laparotomy revealed gross distension of the small bowel and of the large bowel as far as the splenic flexure. Beyond this, the colon was collapsed and no mechanical cause for the apparent obstruction could be found. The small bowel was decompressed.Postoperatively the abdominal distension persisted for several weeks. The patient remained very lethargic and died from bronchopneumonia 3 months later. CUSP 2: A 78-year-old bronchitic and hemiplegic man was admitted as an emergency on 22 June 1969 with chronic retention of urine. His bowel habit had always been regular.Investigations showed a blood urea of 68 mg/100 ml and a WBC of 12 O O O /~I~.~ The haemoglobin and electrolytes were within normal limits.Catheter drainage of the bladder was unsatisfactory and the blood urea rose to 196 mg/100 ml 6 days after admission. Gross abdominal distension with generalized tenderness and guarding then developed. Abdominal X-rays showed multiple fluid levels and gross distension of the transverse colon (Fig. I), while gas was absent from the sigmoid colon. Sigmoidoscopic decompression with a flatus tube proved ineffectual. At laparotomy there was moderate distension of the caecum and ascending and transverse colon. The descending colon was collapsed and what was thought to be a carcinoma of the splenic flexure was felt. Caecostomy was performed.At a further laparotomy 23 weeks later the previously felt mass proved to be merely adhesions between the omentum and spleen. No cause for the apparent obstruction was found. The caecostomy closed spontaneously and the patient later had an uneventful prostatectomy. Case 3 : A 60-year-old man was admitted as an emergency on 16 July 1969 with a 24-hour history of severe central abdominal pain and constipation but no vomiting. The abdomen was a little distended. with generalized tenderness, guarding, rebound tenderness and absent ...

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Section: Causementioning

confidence: 98%

Pseudo-obstruction of the large bowel

1974

Journal of British Surgery

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“…There are many other conditions that mimic colonic pseudo-obstruction which are vascular lesions of gut, lead poisoning, porphyria, acute pancreatitis, acute cholecystitis, acute appendicitis, acute dysentery and morphine overdosage (8).…”

Section: Discussionmentioning

confidence: 99%

Caecal Perforation Secondary to Idiopathic Caecal Dilatation– An Interesting Case

Reddy¹,

Karigalan²

2012

jemds

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ABSTRACT:Acute pseudo-obstruction of the colon(Ogilvie's syndrome) involves acute colonic distension without mechanical obstruction or stercoroma in a previously healthy colon. Colonic pseudo-obstruction can be diffuse or segmental. The cause for idiopathic colon dilatation is not known. Caecal rupture due to colonic ileus is rare and has a mortality rate of 43 per cent. We report a case of idiopathic caecal dilatation causing caecal perforation. On emergency laparotomy, caecal perforation secondary to segmental caecal dilatation without organic obstruction was found in this patient.

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“…These also may be the pre senting symptoms. Intestinal obstruction as a complica tion of amyloidosis has been described, but true organic mechanical obstruction is rare [ 1 ]. We present the case of a patient in whom a 'functional' intestinal obstruction was a complication of amyloidosis.…”

Section: Introductionmentioning

confidence: 96%

“…Gastrointestinal amyloidosis can be complicated by hemorrhage, ulcer ation, perforation, malabsorption, obstruction and var ious motility disorders [1,2]. These also may be the pre senting symptoms.…”

Section: Introductionmentioning

confidence: 99%

Management of Amyloidosis Presenting as Intestinal Obstruction

Gerst¹,

Deshmukh²,

Ziscovici³

et al. 1990

Dig Surg

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A 55-year-old woman presented with symptoms and signs of intestinal obstruction. At exploratory laparotomy, neither an extra- nor an intraluminal obstructing lesion was found. However, there was a thickened midileal small-bowel segment with an abnormal mesentery and a significant proximal dilatation. Wide resection of the involved segment was performed. Histology of the resected specimen yielded the diagnosis of amyloidosis. The management of functional obstruction (pseudo-obstruction) of the small intestine caused by amyloidosis is discussed and the literature on this subject is reviewed.

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Syndrome of Intestinal Pseudo-obstruction

Cited by 51 publications

References 5 publications

Pseudo-obstruction of the large bowel

Pseudo-obstruction of the large bowel

Caecal Perforation Secondary to Idiopathic Caecal Dilatation– An Interesting Case

Management of Amyloidosis Presenting as Intestinal Obstruction

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