Gastrointestinal pseudo-obstruction: report of a patient with postoperative pseudo-obstruction.
Postoperative pseudo-obstruction is a rare state of protracted gastrointestinal paresis that may progress to paralysis without the presence of obstructive lesions. Pseudo-obstruction is usually, but not exclusively, associated with an abdominal operative procedure (laparotomy), however, it may occasionally occur following extra-abdominal operations. As differentiated from the usual, 'physiologic'postoperative paresis, pseudo-obstruction persists for more than 7 days. The pathogenesis of postoperative pseudo-obstruction is complex and as yet partially unknown. Whereas the 'physiologic' postoperative gastrointestinal paresis includes short-term functional cholinergic depression of the visceral organs, in pseudo-obstruction focal lesions in the region of Auerbach's plexus, manifesting as visceral neuromyopathy, are involved. That is why the 'physiologic' postoperative paresis never transforms into paralytic ileus, while in pseudo-obstruction such a risk is potentially involved. The treatment for pseudo-obstruction is as a rule conservative. Surgical treatment (cecostomy) is rarely required. Colonoscopic decompresive suction is usually enough to eliminate the risk of colon rupture due to extensive distention by fast growing meteorism. A patient with postoperative pseudo-obstruction is presented.
Huis
M
M
Department of Surgery, General Hospital Zabok, Croatia.
Balija
M
M
Stulhofer
M
M
D000368:Aged; D003106:Colon / Q000473:pathology; D003113:Colonoscopy; D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D008297:Male; D011183:Postoperative Complications; D012307:Risk Factors