PDF(Pubmed)
Abstract：
Several gastrointestinal complications have been reported in patients with COVID-19, including motility disorders, such as acute colonic pseudo-obstruction (ACPO). This affection is characterized by colonic distention in the absence of mechanical obstruction. ACPO in the context of severe COVID-19 may be related to neurotropism and direct damage of SARS-CoV-2 in enterocytes.
We conducted a retrospective study of patients who were hospitalized for critical COVID-19 and developed ACPO between March 2020 and September 2021. The diagnostic criteria to define ACPO was the presence of 2 or more of the following: abdominal distension, abdominal pain, and changes in the bowel movements, associated with distension of the colon in computed tomography. Data of sex, age, past medical history, treatment, and outcomes were collected.
Five patients were detected. All required admission to the Intensive Care Unit. The ACPO syndrome developed with a mean of 33.8 days from the onset of symptoms. The mean duration of the ACPO syndrome was 24.6 days. The treatment included colonic decompression with placement of rectal and nasogastric tubes, endoscopy decompression in two patients, bowel rest, fluid, and electrolytes replacement. One patient died. The remaining resolved the gastrointestinal symptoms without surgery.
ACPO is an infrequent complication in patients with COVID-19. It occurs especially in patients with critical condition, who require prolonged stays in intensive care and multiple pharmacological treatments. It is important to recognize its presence early and thus establish an appropriate treatment, since the risk of complications is high.
We conducted a retrospective study of patients who were hospitalized for critical COVID-19 and developed ACPO between March 2020 and September 2021. The diagnostic criteria to define ACPO was the presence of 2 or more of the following: abdominal distension, abdominal pain, and changes in the bowel movements, associated with distension of the colon in computed tomography. Data of sex, age, past medical history, treatment, and outcomes were collected.
Five patients were detected. All required admission to the Intensive Care Unit. The ACPO syndrome developed with a mean of 33.8 days from the onset of symptoms. The mean duration of the ACPO syndrome was 24.6 days. The treatment included colonic decompression with placement of rectal and nasogastric tubes, endoscopy decompression in two patients, bowel rest, fluid, and electrolytes replacement. One patient died. The remaining resolved the gastrointestinal symptoms without surgery.
ACPO is an infrequent complication in patients with COVID-19. It occurs especially in patients with critical condition, who require prolonged stays in intensive care and multiple pharmacological treatments. It is important to recognize its presence early and thus establish an appropriate treatment, since the risk of complications is high.
摘要：
背景：已经报道了COVID-19患者的几种胃肠道并发症，包括运动障碍，如急性结肠假性梗阻（ACPO）。这种影响的特征是在没有机械阻塞的情况下结肠扩张。在严重COVID-19的情况下，ACPO可能与肠细胞中SARS-CoV-2的神经嗜性和直接损害有关。
方法：我们对2020年3月至2021年9月期间因重症COVID-19住院并开发ACPO的患者进行了回顾性研究。定义ACPO的诊断标准是存在以下2种或更多种情况：腹胀，腹痛,以及排便的变化，在计算机断层扫描中与结肠扩张有关。性别数据，年龄,既往病史,治疗,并收集结果。
结果：发现5例患者。所有这些都需要进入重症监护病房。ACPO综合征从症状发作开始平均33.8天。ACPO综合征的平均持续时间为24.6天。治疗包括结肠减压，放置直肠和鼻胃管，对两名患者进行内镜减压，肠道休息,流体,和电解质的更换。一名患者死亡。其余的在没有手术的情况下解决了胃肠道症状。
结论：ACPO是COVID-19患者的罕见并发症。它尤其发生在病情危重的患者中，谁需要长期停留在重症监护和多种药物治疗。重要的是要及早认识到它的存在，从而建立适当的治疗方法，因为并发症的风险很高。
方法：我们对2020年3月至2021年9月期间因重症COVID-19住院并开发ACPO的患者进行了回顾性研究。定义ACPO的诊断标准是存在以下2种或更多种情况：腹胀，腹痛,以及排便的变化，在计算机断层扫描中与结肠扩张有关。性别数据，年龄,既往病史,治疗,并收集结果。
结果：发现5例患者。所有这些都需要进入重症监护病房。ACPO综合征从症状发作开始平均33.8天。ACPO综合征的平均持续时间为24.6天。治疗包括结肠减压，放置直肠和鼻胃管，对两名患者进行内镜减压，肠道休息,流体,和电解质的更换。一名患者死亡。其余的在没有手术的情况下解决了胃肠道症状。
结论：ACPO是COVID-19患者的罕见并发症。它尤其发生在病情危重的患者中，谁需要长期停留在重症监护和多种药物治疗。重要的是要及早认识到它的存在，从而建立适当的治疗方法，因为并发症的风险很高。
