Intestinal Pseudo-Obstruction

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The term intestinal pseudo-obstruction denotes a syndrome characterized by a clinical picture suggestive of mechanical obstruction in the absence of any demonstrable evidence of such an obstruction in the intestine. ^[1] On the basis of the clinical presentation, pseudo-obstruction syndromes can be divided into acute and chronic forms. In acute colonic pseudo-obstruction (ACPO ^[2] ; also referred to as Ogilvie syndrome ^[3] ), the colon may become massively dilated; if it is not decompressed, the patient risks perforation, peritonitis, and death. The mortality rate can be as high as 40% when perforation occurs.

Every effort should be made to prevent ACPO in hospitalized and postoperative patients with serious concurrent medical and surgical conditions. Earlier mobilization and positioning of hospitalized patients has become an important preventive strategy in this regard. Furthermore, prevention of colonic distention through more aggressive use of bowel regimens for the prevention of obstipation is critically important in hospitalized patients, who are particularly susceptible to this clinical condition.

The development of new and effective pharmacologic agents for the treatment of ACPO would substantially reduce the need for surgical intervention, which is associated with considerable morbidity and mortality. It is to be hoped that such agents will become available in the future.

Because ACPO can recur, patients and families should be offered counseling about this disease process. They should be educated regarding the signs and symptoms of recurrent pseudo-obstruction and should be informed that recurrent abdominal distention warrants prompt medical attention.

Chronic colonic pseudo-obstruction (CCPO) also exists and should be distinguished from patients with ACPO. Criteria for CCPO include symptoms of recurrent bowel obstruction in the last 6 months, abdominal bloating and/or pain in the previous 3 months, evidence of bowel obstruction on radiographic imaging, and no evidence of anatomic/structural abnormality. ^[4]

The large intestine may be divided into the following parts:

Cecum

Ascending colon

Hepatic flexure

Transverse colon

Splenic flexure

Descending colon

Sigmoid colon

Rectum

The cecum is located in the right iliac fossa. In comparison with the descending colon, sigmoid colon, and rectum, the cecum and ascending colon are saccular, are larger in diameter, and have thinner walls.

The largest dilatations in ACPO patients usually develop in the cecum. According to Laplace’s law, the intraluminal pressure needed to stretch the wall of a hollow tube is inversely proportional to its diameter. Accordingly, the cecum, with its larger diameter, requires less pressure to increase in size and in wall tension. As the wall tension of the colon increases, ischemia with longitudinal splitting of the serosa, herniation of the mucosa, and perforation (including iatrogenic perforation during open or laparoscopic procedures) can occur.

The vagus nerve supplies the parasympathetic tone from the upper gastrointestinal (GI) tract to the splenic flexure, and the sacral parasympathetic nerves (S2 to S5) supply the left colon, sigmoid, and rectum. Sympathetic stimuli result in the inhibition of bowel motility and the contraction of sphincters. The lower 6 thoracic segments supply the sympathetic tone to the right colon, whereas lumbar segments 1-3 supply the left colon. ^{[5, 6]}

The exact pathophysiology of intestinal pseudo-obstruction remains to be elucidated. ^[7] Current theories continue to suggest the idea of an imbalance in the autonomic nervous system. These theories focus on the increased sympathetic tone, the decreased parasympathetic tone, or a combination of both as the cause of intestinal pseudo-obstruction. ^{[8, 9]}

One theory, examined in a 1988 study by Lee et al, is that increased sympathetic tone to the colon results in the inhibition of colonic motility. ^[10] By using epidural anesthesia to block the splanchnic sympathetics, the authors successfully treated several patients whose ACPO did not respond to conservative management. ^[11] A subsequent report on the use of spinal anesthesia for the treatment of Ogilvie syndrome supported this hypothesis. ^[12]

Another theory regarding the etiology of intestinal pseudo-obstruction focuses on parasympathetic tone. According to this theory, the nature of the parasympathetic distribution (see Etiology) suggests that disruption of the sacral innervation may leave the distal colon atonic, thus resulting in a functional obstruction. ^{[8, 11, 13, 14]} This hypothesis is consistent with studies showing a transition between a dilated and collapsed bowel that is often at or near the splenic flexure. ^{[15, 16]}

Other investigators believe that the disorder is a result of a combination of increased sympathetic tone and decreased parasympathetic tone. In 1992, Hutchinson et al reported successfully treating 8 of 11 patients with colonic pseudo-obstruction by using the sympathetic adrenergic blocker guanethidine, followed by the cholinesterase inhibitor neostigmine. ^[17]

The pathophysiology of ACPO has been studied in Sprague-Dawley male rats. ^[18] Partial colonic obstruction was created by placing a medical-grade silicon ring that was 3 mm wide and 1-2 mm longer than the outer circumference of the rat colon. The sham control rats underwent the same procedure with immediate removal of the ring at the completion of the procedure. Accumulation of stool pellets created the partial colonic pseudo-obstruction in rats with silicon rings.

The investigators examined 3-cm long colonic segments that included both obstructed and nonobstructed portions and found that the expression of cyclooxygenase (COX)-2 mRNA was drastically increased in only the obstructed and distended colonic portions. ^[18] (Mechanical stretch in obstruction induces the marked expression of COX-2, and COX-2 plays an important role in suppression of smooth muscle contractility.) The upregulation of COX-2 started at 12 hours after the pseudo-obstruction and lasted about 7 days.

A more recent proposal regarding the mechanism underlying symptomatic chronic intestinal pseudo-obstruction (CIPO) suggests involvement of the transition zone (TZ) between the dilated and nondilated bowel loops, leading to proximal distention and smooth muscle hypertrophy. ^[7] Deficiency in myenteric ganglia and neuronal nitric oxide synthase positive cells, particularly affecting the TZ, could be an important contributing factor. ^[7]

The causes of ACPO are multifactorial. The 3 most common associations are the following:

Trauma (especially retroperitoneal)

Serious infection

Cardiac disease (especially myocardial infarction and congestive heart failure)

Other conditions commonly associated with colonic pseudo-obstruction are as follows:

Recent surgery (abdominal, urologic, gynecologic, orthopedic, cardiac, or neurologic)

Spinal cord injury

Old age

Neurologic disorders

Hypothyroidism

Electrolyte imbalances (hyponatremia ,hypokalemia ,hypocalcemia ,hypercalcemia , orhypomagnesemia )

Respiratory disorders

Renal insufficiency

Medications (eg, narcotics, tricyclic antidepressants, phenothiazines, antiparkinsonian drugs, and anesthetic agents)

Severe constipation ^[19]

The condition may also observed in patients with the following:

Intestinal hypoperistalsis syndrome

Megacystis megacolon

Amyloidosis

GI carcinoma

Guillain-Barré syndrome

Multiple myeloma

Alcohol abuse

Systemic lupus erythematosus (SLE) (rare) ^{[20, 21, 22]}

Systemic sclerosis (rare) ^[23]

In studies involving more than 13,000 orthopedic and burn patients, the prevalence of ACPO was 0.29%. ^{[24, 25]} The frequency in patients undergoing major orthopedic surgery may be higher, with reported rates of 0.65-1.3%. ^[26] The true incidence of this disorder remains largely unknown because of the possibility of spontaneous resolution.

ACPO generally develops in hospitalized patients and is associated with a variety of medical and surgical conditions. Studies have documented that as many as 95% of cases of ACPO are associated with medical or surgical conditions, with the rest being classified as idiopathic. ^{[2, 27, 28]} The most commonly associated conditions include trauma; pregnancy; cesarean delivery; severe infections; and cardiothoracic, pelvic, or orthopedic surgery. ^{[29, 30, 31, 32]}

Because ACPO is a rare clinical condition internationally, it is difficult to gather solid epidemiologic studies, particularly in regard to frequency.

Although intestinal pseudo-obstruction may occur in younger patients, particularly those with underlying spinal cord disorders, it is generally a disease of elderly patients. In fact, the mean age of patients with ACPO appears to be increasing.

In 1986, Vanek et al reviewed more than 400 cases of colonic pseudo-obstruction occurring between 1970 and 1985 and reported a mean patient age of 56.5 years for females and 59.9 years for males. ^[16] In the late 1980s, other reports also found mean ages to fall into the sixth decade. ^{[33, 34]} Since then, several reports have documented a rise in the mean age of ACPO patients, with most now finding the mean age to fall into the seventh and eighth decades of life. ^{[25, 32, 35, 36]}

Unlike the age distribution, the male-to-female ratio has apparently remained constant over the years. In the view of some, no convincing data suggest that frequency differs significantly according to sex; however, some researchers suggest that intestinal pseudo-obstruction may have a male predominance, possibly in a ratio of 1.5:1 (or even as high as 4:1). ^{[16, 33, 37, 38]}

No data suggest that frequency differs according to race.

Generally, the overall medical status of patients with ACPO is poor. The prognosis in patients successfully treated for this disorder is directly related to the severity of the underlying medical or surgical conditions that placed the patient at risk for colonic pseudo-obstruction to begin with.

Because of these associated conditions, morbidity and mortality remain high. In 1993, Datta et al documented an annual death rate of 200 patients (most of them elderly and bedridden) in the United Kingdom. ^[39] Mortality has been documented to be 14% in medically treated patients and 30% in surgically treated patients. ^[16] However, with increased awareness, better diagnostic tools, and prompt management of this disorder, mortality is decreasing.

Intestinal pseudo-obstruction is a rare gastrointestinal complication in patients with systemic sclerosis, but it is associated with high inpatient mortality relative to other patients with systemic sclerosis and those with intestinal pseudo-obstruction from other causes. ^[23]

The most serious complication of colonic pseudo-obstruction is perforation of the cecum. The reported incidence of cecal perforation is 3-40%, and the associated mortality is 40-50%. ^{[2, 14, 35]} A cecal diameter greater than 14 cm, a delay in colonic decompression, and advanced age are all predictors of colonic perforation.

Neostigmine should be administered only in patients without any mechanical colonic obstruction. Colonic distention can recur and may necessitate multiple administrations of neostigmine. A single dose of neostigmine is effective for 1-2 hours. Neostigmine is effective in treating 85-90% of cases of ACPO. Recurrent or persistent colonic distention may cause ischemia and perforation. ^[40]

Coulie B, Camilleri M. Intestinal pseudo-obstruction. Annu Rev Med. 1999. 50:37-55. [Medline].

Alwan MH, van Rij AM. Acute colonic pseudo-obstruction. Aust N Z J Surg. 1998 Feb. 68(2):129-32. [Medline].

Ogilvie H. Large-intestine colic due to sympathetic deprivation; a new clinical syndrome. Br Med J. 1948 Oct 9. 2(4579):671-3. [Medline].

Ohkubo H, Iida H, Takahashi H, et al. An epidemiologic survey of chronic intestinal pseudo-obstruction and evaluation of the newly proposed diagnostic criteria. Digestion. 2012. 86(1):12-9. [Medline].

Saunders MD. Acute colonic pseudo-obstruction. Best Pract Res Clin Gastroenterol. 2007. 21(4):671-87. [Medline].

De Giorgio R, Knowles CH. Acute colonic pseudo-obstruction. Br J Surg. 2009 Mar. 96(3):229-39. [Medline].

Do YS, Myung SJ, Kwak SY, et al. Molecular and cellular characteristics of the colonic pseudo-obstruction in patients with intractable constipation. J Neurogastroenterol Motil. 2015 Oct 1. 21(4):560-70. [Medline].

Bachulis BL, Smith PE. Pseudoobstruction of the colon. Am J Surg. 1978 Jul. 136(1):66-72. [Medline].

Manten HD. Pseudo-obstruction. Haubrich WS, Schaffner F, Berk JE eds. Bockus Gastroenterology. Philadelphia: WB Saunders Co; 1995. Vol 2: 1249-67.

Lee JT, Taylor BM, Singleton BC. Epidural anesthesia for acute pseudo-obstruction of the colon (Ogilvie’s syndrome). Dis Colon Rectum. 1988 Sep. 31(9):686-91. [Medline].

Christensen J. Intestinal motor physiology. Sleisenger MH, Fordtran JS, eds. Gastrointestinal Disease: Pathophysiology, Diagnosis, Management. 6th ed. Philadelphia: WB Saunders Co; 1998. 1437-50.

Mashour GA, Peterfreund RA. Spinal anesthesia and Ogilvie’s syndrome. J Clin Anesth. 2005 Mar. 17(2):122-3. [Medline].

Spira IA, Wolff WI. Gangrene and spontaneous perforation of the cecum as a complication of pseudo-obstruction of the colon: report of three cases and speculation as to etiology. Dis Colon Rectum. 1976 Sep. 19(6):557-62. [Medline].

Dorudi S, Berry AR, Kettlewell MG. Acute colonic pseudo-obstruction. Br J Surg. 1992 Feb. 79(2):99-103. [Medline].

Ellis H. Pseudo-obstruction of the colon. Ellis H, ed. Intestinal Obstruction. NY: Appleton-Century-Crofts; 1982. 81-6.

Vanek VW, Al-Salti M. Acute pseudo-obstruction of the colon (Ogilvie’s syndrome). An analysis of 400 cases. Dis Colon Rectum. 1986 Mar. 29(3):203-10. [Medline].

Hutchinson R, Griffiths C. Acute colonic pseudo-obstruction: a pharmacological approach. Ann R Coll Surg Engl. 1992 Sep. 74(5):364-7. [Medline]. [Full Text].

Shi XZ, Lin YM, Powell DW, Sarna SK. Pathophysiology of motility dysfunction in bowel obstruction: role of stretch-induced COX-2. Am J Physiol Gastrointest Liver Physiol. 2011 Jan. 300(1):G99-G108. [Medline].

Breccia M, Girmenia C, Mecarocci S, et al. Ogilvie’s syndrome in acute myeloid leukemia: pharmacological approach with neostigmine. Ann Hematol. 2001 Oct. 80(10):614-6. [Medline].

Garcia Lopez CA, Laredo-Sanchez F, Malagon-Rangel J, Flores-Padilla MG, Nellen-Hummel H. Intestinal pseudo-obstruction in patients with systemic lupus erythematosus: a real diagnostic challenge. World J Gastroenterol. 2014 Aug 28. 20(32):11443-50. [Medline].

Jin P, Ji X, Zhi H, et al. A review of 42 cases of intestinal pseudo-obstruction in patients with systemic lupus erythematosus based on case reports. Hum Immunol. 2015 Sep. 76(9):695-700. [Medline].

Huang Q, Lai W, Yuan C, et al. Predictors of intestinal pseudo-obstruction in systemic lupus erythematosus complicated by digestive manifestations: data from a Southern China lupus cohort. Lupus. 2016 Mar. 25(3):248-54. [Medline].

Valenzuela A, Li S, Becker L, et al. Intestinal pseudo-obstruction in patients with systemic sclerosis: an analysis of the Nationwide Inpatient Sample. Rheumatology (Oxford). 2016 Apr. 55(4):654-8. [Medline].

Kadesky K, Purdue GF, Hunt JL. Acute pseudo-obstruction in critically ill patients with burns. J Burn Care Rehabil. 1995 Mar-Apr. 16(2 Pt 1):132-5. [Medline].

Clarke HD, Berry DJ, Larson DR. Acute pseudo-obstruction of the colon as a postoperative complication of hip arthroplasty. J Bone Joint Surg Am. 1997 Nov. 79(11):1642-7. [Medline].

Norwood MG, Lykostratis H, Garcea G, Berry DP. Acute colonic pseudo-obstruction following major orthopaedic surgery. Colorectal Dis. 2005 Sep. 7(5):496-9. [Medline].

Nanni G, Garbini A, Luchetti P, Nanni G, Ronconi P, Castagneto M. Ogilvie’s syndrome (acute colonic pseudo-obstruction): review of the literature (October 1948 to March 1980) and report of four additional cases. Dis Colon Rectum. 1982 Mar. 25(2):157-66. [Medline].

Laine L. Management of acute colonic pseudo-obstruction. N Engl J Med. 1999 Jul 15. 341(3):192-3. [Medline].

Ravo B, Pollane M, Ger R. Pseudo-obstruction of the colon following cesarean section. A review. Dis Colon Rectum. 1983 Jul. 26(7):440-4. [Medline].

Geelhoed GW. Colonic pseudo-obstruction in surgical patients. Am J Surg. 1985 Feb. 149(2):258-65. [Medline].

Anuras S, Baker CR Jr. The colon in the pseudoobstructive syndrome. Clin Gastroenterol. 1986 Oct. 15(4):745-62. [Medline].

Tenofsky PL, Beamer L, Smith RS. Ogilvie syndrome as a postoperative complication. Arch Surg. 2000 Jun. 135(6):682-6; discussion 686-7. [Medline].

Fausel CS, Goff JS. Nonoperative management of acute idiopathic colonic pseudo-obstruction (Ogilvie’s syndrome). West J Med. 1985 Jul. 143(1):50-4. [Medline]. [Full Text].

Sloyer AF, Panella VS, Demas BE, et al. Ogilvie’s syndrome. Successful management without colonoscopy. Dig Dis Sci. 1988 Nov. 33(11):1391-6. [Medline].

Geller A, Petersen BT, Gostout CJ. Endoscopic decompression for acute colonic pseudo-obstruction. Gastrointest Endosc. 1996 Aug. 44(2):144-50. [Medline].

Paran H, Silverberg D, Mayo A, Shwartz I, Neufeld D, Freund U. Treatment of acute colonic pseudo-obstruction with neostigmine. J Am Coll Surg. 2000 Mar. 190(3):315-8. [Medline].

Marinella MA. Acute colonic pseudo-obstruction complicated by cecal perforation in a patient with Parkinson’s disease. South Med J. 1997 Oct. 90(10):1023-6. [Medline].

Trevisani GT, Hyman NH, Church JM. Neostigmine: safe and effective treatment for acute colonic pseudo-obstruction. Dis Colon Rectum. 2000 May. 43(5):599-603. [Medline].

Datta SN, Stephenson BM, Havard TJ, Salaman JR. Acute colonic pseudo-obstruction. Lancet. 1993 Mar 13. 341(8846):690. [Medline].

Halverson A. Acute colonic pseudoobstruction. Cameron JL, ed. Current Surgical Therapy. 9th ed. Philadelphia: Mosby-Elsevier; 2008. 192-5.

Grassi R, Cappabianca S, Porto A, et al. Ogilvie’s syndrome (acute colonic pseudo-obstruction): review of the literature and report of 6 additional cases. Radiol Med. 2005 Apr. 109(4):370-5. [Medline].

De Giorgio R, Cogliandro RF, Barbara G, Corinaldesi R, Stanghellini V. Chronic intestinal pseudo-obstruction: clinical features, diagnosis, and therapy. Gastroenterol Clin North Am. 2011 Dec. 40(4):787-807. [Medline].

Choi JS, Lim JS, Kim H, et al. Colonic pseudoobstruction: CT findings. AJR Am J Roentgenol. 2008 Jun. 190(6):1521-6. [Medline].

Nivatvongs S, Vermeulen FD, Fang DT. Colonoscopic decompression of acute pseudo-obstruction of the colon. Ann Surg. 1982 Nov. 196(5):598-600. [Medline]. [Full Text].

Anuras S, Shirazi SS. Colonic pseudoobstruction. Am J Gastroenterol. 1984 Jul. 79(7):525-32. [Medline].

Gilchrist AM, Mills JO, Russell CG. Acute large-bowel pseudo-obstruction. Clin Radiol. 1985 Jul. 36(4):401-4. [Medline].

Low VH. Colonic pseudo-obstruction: value of prone lateral view of the rectum. Abdom Imaging. 1995 Nov-Dec. 20(6):531-3. [Medline].

Stewart J, Finan PJ, Courtney DF, Brennan TG. Does a water soluble contrast enema assist in the management of acute large bowel obstruction: a prospective study of 117 cases. Br J Surg. 1984 Oct. 71(10):799-801. [Medline].

Koruth NM, Koruth A, Matheson NA. The place of contrast enema in the management of large bowel obstruction. J R Coll Surg Edinb. 1985 Aug. 30(4):258-60. [Medline].

Finan PJ, Stewart J, Brennan TG. Pseudo-obstruction. Br Med J (Clin Res Ed). 1986 Jun 14. 292(6535):1594-5. [Medline]. [Full Text].

Edelman DA, Antaki F, Basson MD, Salwen WA, Gruber SA, Losanoff JE. Ogilvie syndrome and herpes zoster: case report and review of the literature. J Emerg Med. 2010 Nov. 39(5):696-700. [Medline].

McNamara R, Mihalakis MJ. Acute colonic pseudo-obstruction: rapid correction with neostigmine in the emergency department. J Emerg Med. 2008 Aug. 35(2):167-70. [Medline].

Lauro A, De Giorgio R, Pinna AD. Advancement in the clinical management of intestinal pseudo-obstruction. Expert Rev Gastroenterol Hepatol. 2015 Feb. 9(2):197-208. [Medline].

Catchpole BN. Ileus: use of sympathetic blocking agents in its treatment. Surgery. 1969 Nov. 66(5):811-20. [Medline].

Stephenson BM, Morgan AR, Salaman JR, Wheeler MH. Ogilvie’s syndrome: a new approach to an old problem. Dis Colon Rectum. 1995 Apr. 38(4):424-7. [Medline].

Turegano-Fuentes F, Munoz-Jimenez F, Del Valle-Hernandez E, et al. Early resolution of Ogilvie’s syndrome with intravenous neostigmine: a simple, effective treatment. Dis Colon Rectum. 1997 Nov. 40(11):1353-7. [Medline].

[Guideline] Harrison ME, Anderson MA, Appalaneni V, et al. The role of endoscopy in the management of patients with known and suspected colonic obstruction and pseudo-obstruction. Gastrointest Endosc. 2010 Apr. 71(4):669-79. [Medline]. [Full Text].

Jain A, Vargas HD. Advances and challenges in the management of acute colonic pseudo-obstruction (ogilvie syndrome). Clin Colon Rectal Surg. 2012 Mar. 25(1):37-45. [Medline]. [Full Text].

Lee KJ, Jung KW, Myung SJ, et al. The clinical characteristics of colonic pseudo-obstruction and the factors associated with medical treatment response: a study based on a multicenter database in Korea. J Korean Med Sci. 2014 May. 29 (5):699-703. [Medline].

Phillips S, Pemberton JH. Acute megacolon. Feldman M, Scharschmidt BF, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal Disease: Pathophysiology, Diagnosis, Management. 6th ed. Philadelphia: WB Saunders Co; 1998. 1817-18.

Bjorgen J, Bonella F. Gravity treatment of pseudo-obstruction of the colon. Minn Med. 1987 Nov. 70(11):623. [Medline].

Wegener M, Borsch G. Acute colonic pseudo-obstruction (Ogilvie’s syndrome). Presentation of 14 of our own cases and analysis of 1027 cases reported in the literature. Surg Endosc. 1987. 1(3):169-74. [Medline].

Attar A, Lemann M, Ferguson A, et al. Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation. Gut. 1999 Feb. 44(2):226-30. [Medline]. [Full Text].

Rex DK. Colonoscopy and acute colonic pseudo-obstruction. Gastrointest Endosc Clin N Am. 1997 Jul. 7(3):499-508. [Medline].

Cakir E, Baykal S, Usul H, Kuzeyli K, Cinel A. Ogilvie’s syndrome after cervical discectomy. Clin Neurol Neurosurg. 2001 Dec. 103(4):232-3. [Medline].

Bonacini M, Smith OJ, Pritchard T. Erythromycin as therapy for acute colonic pseudo-obstruction (Ogilvie’s syndrome). J Clin Gastroenterol. 1991 Aug. 13(4):475-6. [Medline].

Mazloum BW, Barnes JB, Lee M. Cisapride as a successful treatment for acute intestinal pseudo-obstruction. South Med J. 1996 Aug. 89(8):828-30. [Medline].

Ponec RJ, Saunders MD, Kimmey MB. Neostigmine for the treatment of acute colonic pseudo-obstruction. N Engl J Med. 1999 Jul 15. 341(3):137-41. [Medline].

Saunders MD, Kimmey MB. Systematic review: acute colonic pseudo-obstruction. Aliment Pharmacol Ther. 2005 Nov 15. 22(10):917-25. [Medline].

Tsirline VB, Zemlyak AY, Avery MJ, et al. Colonoscopy is superior to neostigmine in the treatment of Ogilvie’s syndrome. Am J Surg. 2012 Dec. 204(6):849-55; discussion 855. [Medline].

De Giorgio R, Barbara G, Stanghellini V, et al. Review article: the pharmacological treatment of acute colonic pseudo-obstruction. Aliment Pharmacol Ther. 2001 Nov. 15(11):1717-27. [Medline].

Abeyta BJ, Albrecht RM, Schermer CR. Retrospective study of neostigmine for the treatment of acute colonic pseudo-obstruction. Am Surg. 2001 Mar. 67(3):265-8; discussion 268-9. [Medline].

van der Spoel JI, Oudemans-van Straaten HM, Stoutenbeek CP, Bosman RJ, Zandstra DF. Neostigmine resolves critical illness-related colonic ileus in intensive care patients with multiple organ failure–a prospective, double-blind, placebo-controlled trial. Intensive Care Med. 2001 May. 27(5):822-7. [Medline].

St John PH, Radcliffe AG. Contraindication for the use of neostigmine in colonic pseudo-obstruction. Br J Surg. 1997 Oct. 84(10):1481-2. [Medline].

O’Dea CJ, Brookes JH, Wattchow DA. The efficacy of treatment of patients with severe constipation or recurrent pseudo-obstruction with pyridostigmine. Colorectal Dis. 2010 Jun. 12(6):540-8. [Medline].

Kukora JS, Dent TL. Colonoscopic decompression of massive nonobstructive cecal dilation. Arch Surg. 1977 Apr. 112(4):512-7. [Medline].

Bode WE, Beart RW Jr, Spencer RJ, Culp CE, Wolff BG, Taylor BM. Colonoscopic decompression for acute pseudoobstruction of the colon (Ogilvie’s syndrome). Report of 22 cases and review of the literature. Am J Surg. 1984 Feb. 147(2):243-5. [Medline].

Strodel WE, Nostrant TT, Eckhauser FE, Dent TL. Therapeutic and diagnostic colonoscopy in nonobstructive colonic dilatation. Ann Surg. 1983 Apr. 197(4):416-21. [Medline]. [Full Text].

Jetmore AB, Timmcke AE, Gathright JB Jr, Hicks TC, Ray JE, Baker JW. Ogilvie’s syndrome: colonoscopic decompression and analysis of predisposing factors. Dis Colon Rectum. 1992 Dec. 35(12):1135-42. [Medline].

Bernton E, Myers R, Reyna T. Pseudoobstruction of the colon: case report including a new endoscopic treatment. Gastrointest Endosc. 1982 May. 28(2):90-2. [Medline].

Fiorito JJ, Schoen RE, Brandt LJ. Pseudo-obstruction associated with colonic ischemia: successful management with colonoscopic decompression. Am J Gastroenterol. 1991 Oct. 86(10):1472-6. [Medline].

Pham TN, Cosman BC, Chu P, Savides TJ. Radiographic changes after colonoscopic decompression for acute pseudo-obstruction. Dis Colon Rectum. 1999 Dec. 42(12):1586-91. [Medline].

Gosche JR, Sharpe JN, Larson GM. Colonoscopic decompression for pseudo-obstruction of the colon. Am Surg. 1989 Feb. 55(2):111-5. [Medline].

Messmer JM, Wolper JC, Loewe CJ. Endoscopic-assisted tube placement for decompression of acute colonic pseudo-obstruction. Endoscopy. 1984 Jul. 16(4):135-6. [Medline].

Burke G, Shellito PC. Treatment of recurrent colonic pseudo-obstruction by endoscopic placement of a fenestrated overtube. Report of a case. Dis Colon Rectum. 1987 Aug. 30(8):615-9. [Medline].

Harig JM, Fumo DE, Loo FD, et al. Treatment of acute nontoxic megacolon during colonoscopy: tube placement versus simple decompression. Gastrointest Endosc. 1988 Jan-Feb. 34(1):23-7. [Medline].

Schermer CR, Hanosh JJ, Davis M, Pitcher DE. Ogilvie’s syndrome in the surgical patient: a new therapeutic modality. J Gastrointest Surg. 1999 Mar-Apr. 3(2):173-7. [Medline].

Sgouros SN, Vlachogiannakos J, Vassiliadis K, et al. Effect of polyethylene glycol electrolyte balanced solution on patients with acute colonic pseudo obstruction after resolution of colonic dilation: a prospective, randomised, placebo controlled trial. Gut. 2006 May. 55(5):638-42. [Medline]. [Full Text].

Bernardi MP, Warrier S, Lynch AC, Heriot AG. Acute and chronic pseudo-obstruction: a current update. ANZ J Surg. 2015 Oct. 85(10):709-14. [Medline].

Carcoforo P, Jorizzo EF, Maestroni U, Soliani G, Bergossi L, Pozza E. A new approach to the cure of the Ogilvie’s syndrome. Ann Ital Chir. 2005 Jan-Feb. 76(1):65-70. [Medline].

Georgescu S, Dubei L, Zaharia M, et al. Ogilvie’s syndrome–acute colonic pseudo-obstruction. Case report and review of the literature. Rom J Gastroenterol. 2003 Mar. 12(1):51-5. [Medline].

Duh QY, Way LW. Diagnostic laparoscopy and laparoscopic cecostomy for colonic pseudo-obstruction. Dis Colon Rectum. 1993 Jan. 36(1):65-70. [Medline].

Choe EK, Park SH, Park KJ. Colonic pseudo-obstruction with distinct transitional zone in adult constipation patients: pathological analysis and results of surgical treatment. Am Surg. 2011 Jun. 77(6):736-42. [Medline].

Molina-Infante J, Mateos-Rodriguez JM, Vinagre-Rodriguez G, Martin-Noguerol E, Santiago JM. Endoscopic-assisted colopexy and push percutaneous colostomy in the transverse colon for refractory chronic intestinal pseudo-obstruction. Surg Laparosc Endosc Percutan Tech. 2011 Dec. 21(6):e322-5. [Medline].

Menys A, Butt S, Emmanuel A, et al. Comparative quantitative assessment of global small bowel motility using magnetic resonance imaging in chronic intestinal pseudo-obstruction and healthy controls. Neurogastroenterol Motil. 2016 Mar. 28(3):376-83. [Medline].

Shirley L, Thundyil RJ. A frequently missed entity in systemic lupus erythematosus (SLE): Intestinal pseudo-obstruction (IpsO). Med J Malaysia. 2017 Dec. 72(6):374-5. [Medline]. [Full Text].

Wu J, Wang Y, Wang C. Amyloidosis: an unusual cause of intestinal pseudo-obstruction. Clin Gastroenterol Hepatol. 2018 May. 16(5):e53-e54. [Medline].

Haj M, Haj M, Rockey DC. Ogilvie’s syndrome: management and outcomes. Medicine (Baltimore). 2018 Jul. 97(27):e11187. [Medline]. [Full Text].

Downes TJ, Cheruvu MS, Karunaratne TB, De Giorgio R, Farmer AD. Pathophysiology, diagnosis, and management of chronic intestinal pseudo-obstruction. J Clin Gastroenterol. 2018 Jul. 52(6):477-89. [Medline].

Burt Cagir, MD, FACS Clinical Professor of Surgery, The Commonwealth Medical College; Director, General Surgery Residency Program, Robert Packer Hospital; Attending Surgeon, Robert Packer Hospital and Corning Hospital

Burt Cagir, MD, FACS is a member of the following medical societies: American College of Surgeons, American Medical Association, Society for Surgery of the Alimentary Tract

Disclosure: Nothing to disclose.

Lena M Napolitano, MD, FACS, FCCM, FCCP Professor of Surgery, University of Michigan School of Medicine; Chief, Surgical Critical Care, Program Director, Surgical Critical Care Fellowship, Associate Chair, Department of Surgery, University of Michigan Health System

Lena M Napolitano, MD, FACS, FCCM, FCCP is a member of the following medical societies: Alpha Omega Alpha, American Association for the Surgery of Trauma, American College of Chest Physicians, American College of Critical Care Medicine, American College of Physicians, American College of Surgeons, American Medical Association, American Society for Parenteral and Enteral Nutrition, Association for Academic Surgery, Association of VA Surgeons, Association of Women Surgeons, California Professional Society on the Abuse of Children, Eastern Association for the Surgery of Trauma, Phi Beta Kappa, Shock Society, Society of Critical Care Medicine, Society of University Surgeons

Disclosure: Nothing to disclose.

James Dunne, MD Clinical Instructor, Department of Surgery, Trauma/Critical Care, University of Maryland Medical Center

James Dunne, MD is a member of the following medical societies: Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Prospere Remy, MD Assistant Professor of Medicine, Albert Einstein College of Medicine; Attending Physician, Department of Internal Medicine, Bronx-Lebanon Hospital Center

Prospere Remy, MD is a member of the following medical societies: American College of Physicians, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

John Geibel, MD, DSc, MSc, AGAF Vice Chair and Professor, Department of Surgery, Section of Gastrointestinal Medicine, Professor, Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director of Surgical Research, Department of Surgery, Yale-New Haven Hospital; American Gastroenterological Association Fellow

John Geibel, MD, DSc, MSc, AGAF is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, Society for Surgery of the Alimentary Tract

Disclosure: Nothing to disclose.

Steven Lee Carpenter, MD, FACP, AGAF, FASGE Academic Chair, Associate Professor of Medicine, Department of Internal Medicine, Internal Medicine Program Director, Mercer University School of Medicine; Senior Partner, The Center for Digestive and Liver Health, The Endoscopy Center

Steven Lee Carpenter, MD, FACP, AGAF, FASGE is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Douglas M Heuman, MD, FACP, FACG, AGAF Chief of GI, Hepatology, and Nutrition at North Shore University Hospital/Long Island Jewish Medical Center; Professor, Department of Medicine, Hofstra North Shore-LIJ School of Medicine

Douglas M Heuman, MD, FACP, FACG, AGAF is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Physicians, and American Gastroenterological Association

Disclosure: Novartis Grant/research funds Other; Bayer Grant/research funds Other; Otsuka Grant/research funds None; Bristol Myers Squibb Grant/research funds Other; Scynexis None None; Salix Grant/research funds Other; MannKind Other

Bjorn Holmstrom, MD Assistant Professor, Department of Internal Medicine, University of South Florida

Bjorn Holmstrom, MD is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine, American Medical Association, Medical Association of Georgia, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Julian Katz, MD Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Kavitha Kumbum, MD Associate Program Director and Attending Physician, Gastroenterology Fellowship Program, Division of Gastroenterology, Bronx Lebanon Hospital Center, Albert Einstein College of Medicine

Kavitha Kumbum, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, and New York Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Prospere Remy, MD Assistant Professor of Medicine, Albert Einstein College of Medicine; Attending Physician, Department of Internal Medicine, Bronx-Lebanon Hospital Center

Prospere Remy, MD is a member of the following medical societies: American College of Physicians and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

George Y Wu, MD, PhD Professor, Department of Medicine, Director, Hepatology Section, Herman Lopata Chair in Hepatitis Research, University of Connecticut School of Medicine

George Y Wu, MD, PhD is a member of the following medical societies: American Association for the Study of Liver Diseases, American Gastroenterological Association, American Medical Association, American Society for Clinical Investigation, and Association of American Physicians

Disclosure: Springer Consulting fee Consulting; Gilead Consulting fee Review panel membership; Gilead Honoraria Speaking and teaching; Bristol-Myers Squibb Honoraria Speaking and teaching; Springer Royalty Review panel membership

Intestinal Pseudo-Obstruction

Research & References of Intestinal Pseudo-Obstruction|A&C Accounting And Tax Services
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