PDF(Pubmed)
Abstract：
Acute colonic pseudo-obstruction (ACPO) is a severe form of colonic dysmotility and is associated with considerable morbidity. The pathophysiology of ACPO is considered to be multifactorial but has not been clarified. Although colonic motility is commonly assumed to be hypoactive, there is little direct pathophysiological evidence to support this claim.
A 56-year-old woman who developed ACPO following spinal surgery underwent 24 h of continuous high-resolution colonic manometry (1 cm resolution over 36 cm) following endoscopic decompression. Manometry data were analyzed and correlated with a three-dimensional colonic model developed from computed tomography (CT) imaging.
The distal colon was found to be profoundly hyperactive, showing near-continuous non-propagating motor activity. Dominant frequencies at 2-6 and 8-12 cycles per minute were observed. The activity was often dissociated and out-of-phase across adjacent regions. The mean amplitude of motor activity was higher than that reported from pre- and post-prandial healthy controls. Correlation with CT imaging suggested that these disordered hyperactive motility sequences might act as a functional pseudo-obstruction in the distal colon resulting in secondary proximal dilatation.
This is the first detailed description of motility patterns in ACPO and suggests a novel underlying disease mechanism, warranting further investigation and identification of potential therapeutic targets.
A 56-year-old woman who developed ACPO following spinal surgery underwent 24 h of continuous high-resolution colonic manometry (1 cm resolution over 36 cm) following endoscopic decompression. Manometry data were analyzed and correlated with a three-dimensional colonic model developed from computed tomography (CT) imaging.
The distal colon was found to be profoundly hyperactive, showing near-continuous non-propagating motor activity. Dominant frequencies at 2-6 and 8-12 cycles per minute were observed. The activity was often dissociated and out-of-phase across adjacent regions. The mean amplitude of motor activity was higher than that reported from pre- and post-prandial healthy controls. Correlation with CT imaging suggested that these disordered hyperactive motility sequences might act as a functional pseudo-obstruction in the distal colon resulting in secondary proximal dilatation.
This is the first detailed description of motility patterns in ACPO and suggests a novel underlying disease mechanism, warranting further investigation and identification of potential therapeutic targets.
摘要：
急性结肠假性梗阻（ACPO）是结肠运动障碍的一种严重形式，并伴有相当大的发病率。ACPO的病理生理学被认为是多因素的，但尚未阐明。尽管结肠运动通常被认为是不活跃的，几乎没有直接的病理生理学证据支持这一说法。
一名56岁的女性在脊柱手术后出现ACPO，在内窥镜减压后接受了24小时的连续高分辨率结肠测压（1cm分辨率超过36cm）。分析测压数据，并将其与计算机断层扫描（CT）成像开发的三维结肠模型相关联。
发现远端结肠极度活跃，显示近乎连续的非传播运动活动。观察到每分钟2-6和8-12个循环的主导频率。该活性通常在相邻区域中分离和异相。运动活动的平均幅度高于餐前和餐后健康对照的平均幅度。与CT成像的相关性表明，这些无序的活动过度运动序列可能在远端结肠中充当功能性假性阻塞，导致继发性近端扩张。
这是对ACPO运动模式的首次详细描述，并提出了一种新的潜在疾病机制，保证进一步调查和确定潜在的治疗目标。
一名56岁的女性在脊柱手术后出现ACPO，在内窥镜减压后接受了24小时的连续高分辨率结肠测压（1cm分辨率超过36cm）。分析测压数据，并将其与计算机断层扫描（CT）成像开发的三维结肠模型相关联。
发现远端结肠极度活跃，显示近乎连续的非传播运动活动。观察到每分钟2-6和8-12个循环的主导频率。该活性通常在相邻区域中分离和异相。运动活动的平均幅度高于餐前和餐后健康对照的平均幅度。与CT成像的相关性表明，这些无序的活动过度运动序列可能在远端结肠中充当功能性假性阻塞，导致继发性近端扩张。
这是对ACPO运动模式的首次详细描述，并提出了一种新的潜在疾病机制，保证进一步调查和确定潜在的治疗目标。
