#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

False Acute Large Bowel Obstruction


Authors: A. Pelikán;  G. Jain;  A. S. Rajagopal;  M. Shinkfield
Authors place of work: St. Mary‘s Hospital, Newport, Isle of Wight, UK, Department of Surgery, prof. Anton Pelikán Locum Consultant Surgeon
Published in the journal: Rozhl. Chir., 2007, roč. 86, č. 11, s. 608-610.
Category: Monothematic special - Original

Summary

Acute pseudobstruction of the large intestine is also termed the „Ogilvie“ syndrome. The life- threatening condition without obvious mechanical obstruction of the intestine, results from a major enlargement of the large intestine, which, if no therapy is initiated on time, may result in perforation of the right- sided colon, most commonly of the caecum.

In this case study, the patient underwent urgent surgery for incipient caecal perforation. Nor the preoperative plain abdominal x- ray examination, abdominal CT , nor the laparotomy procedure detected any mechanical bowel obstruction. The condition was diagnosed as the Ogilvie syndrome in a chronic renal disorder of the patient. The procedure included transversostomy, drainage of the peritoneal cavity and complex management, and the patient was discharged to homecare on the ninth postoperative day. However, two weeks later, the patient was rehospitalized for bleeding from the stoma site. Colonoscopy detected a small stenosing tumor in the lienal flexure of the large intestine. The case study highlights failure of both the CT and x-ray abdominal examinations (air up to the sigmoid), as well as of the surgical exploration. Therefore, it may be concluded that not all pseudoobstructions are truely „pseudo“.

Key words:
acute pseudoobstruction of the large intestine – Ogilvie syndrome – carcinoma


Zdroje

1. Bode, W. E., Beart, R. W. Jr, Spencer, R. J., Culp, C. E., Wolff, B. G., Taylor, B. M. Colonoscopic decompression for acute pseudo obstruction of the colon (Ogilvie‘s syndrome): Report of 22 cases and review of the literature. Am. J. Surg., 1984, roč. 147, s. 243–255.

2. American Society of Gastrointestinal Endoscopy. Acute colonic pseudo-obstruction. Gastrointestinal Endoscopy, 2002, roč. 56 s. 789–792.

3. Vanek, V. W., Al-Salti, M. Acute pseudo-obstruction of the colon (Ogilvie‘s syndrome). An analysis of 400 cases. Dis. Colon Rectum, 1986, roč. 29, s. 203–210.

4. Gierson, E. D., Storm, F. K., Shaw, W., Coyne, S. K. Caecal rupture due to colonic ileus. Br. J. Surg., 1975, roč. 62, s. 383–386.

5. Ponec, R. J., Saunders, M. D., Kimmey, M. B. Neostigmine for the treatment of acute colonic pseudo-obstruction. NEJM, 1999, roč. 41, s. 137–141.

6. Horton, K. M., Abrams, R. A., Fishman, E. K. Spiral CT of colon cancer; Imaging features and role in management. Radiographics, 2000, roč. 20, s. 419–430.

Štítky
Surgery Orthopaedics Trauma surgery
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#