PDF(Pubmed)
Abstract：
Acute colonic pseudo-obstruction (ACPO) is a functional disorder of the large intestine distinguished by colonic dysmotility resulting in colonic distension in the absence of mechanical obstruction. The underlying pathophysiology of ACPO remains unclear despite technological advances in understanding the physiology of colonic motility, such as spatio-temporal mapping and high-resolution manometry. In many ways, the management of ACPO has remained relatively unchanged for 40 years. Patients with perforation or suspected ischemia undergo operative intervention, while patients without undergo initial conservative management with bowel rest, correction of electrolyte disturbances, and mobilization. Patients who fail conservative management or have prominent cecal dilatation undergo decompression with either neostigmine or colonoscopy. A subset of patients with ACPO will have recurrent symptoms despite endoscopic and medical management. For these patients who are difficult to manage, an underlying colonic functional disorder, such as slow-transit dysmotility or chronic intestinal pseudo-obstruction may be considered. The following review of ACPO aims to provide a concise update of the causes, diagnosis, and management of this emergency surgical condition.
摘要：
急性结肠假性梗阻（ACPO）是大肠的一种功能性疾病，其特征是结肠运动障碍，在没有机械性梗阻的情况下导致结肠扩张。尽管在了解结肠运动的生理学方面取得了技术进步，但ACPO的潜在病理生理学仍不清楚。如时空测绘和高分辨率测压。在许多方面,40年来，ACPO的管理保持相对不变。穿孔或疑似缺血的患者接受手术干预，而没有接受最初保守治疗的患者，校正电解质干扰，和动员。保守治疗失败或盲肠扩张明显的患者接受新斯的明或结肠镜检查减压。尽管进行了内窥镜和医疗管理，但仍有一部分ACPO患者会出现反复症状。对于这些难以管理的患者，一种潜在的结肠功能障碍,如慢传输运动障碍或慢性假性肠梗阻可考虑。以下对ACPO的审查旨在提供原因的简要更新，诊断,和这种紧急手术条件的管理。
