Acute colonic pseudo-obstruction: a pharmacological approach.
Acute colonic pseudo-obstruction is a functional disorder that closely mimics mechanical large bowel obstruction, and in which inadvertent laparotomy carries a high mortality. Eleven such patients were treated by pharmacological manipulation of the autonomic innervation to the colon with guanethidine and neostigmine. Eight responded to treatment with passage of flatus and/or stool within 10 min with complete resolution of symptoms. In three patients the treatment failed. Postural hypotension occurred in only one patient and no other serious side-effect was apparent. This pharmacological approach to the management of acute colonic pseudo-obstruction is suggested as an alternative to the other treatment options of colonoscopic decompression or surgery, when conservative management has failed.
Hutchinson
R
R
Department of Surgery, General Hospital, Birmingham.
Griffiths
C
C
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006145:Guanethidine / Q000627:therapeutic use*; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009388:Neostigmine / Q000627:therapeutic use*; D011446:Prospective Studies
D009388:Neostigmine; D006145:Guanethidine