Intestinal Pseudo – Obstruction Surgery

The syndrome characterized in the clinical picture that would suggest a mechanical obstruction in intestine without any demonstrable evidence of such an obstruction would be known as the intestinal pseudo-obstruction.

As studies show, it can be ramified into two main categories: the chronic form and the acute form. The acute colonic pseudo-obstruction will be a clinical condition that will have signs, symptoms and radiological proof without any mechanical cause as opposed to the chronic one, which will show some evidence of it.

From 1948 when Sir Heneage Ogilvie, when he described three cases of a massive colonic dilatation without any apparent mechanical obstruction, this type was thoroughly studied and patients from then on could opt for the much better choice in treatment.

Scientists stated that more than 14000 burn and orthopedic patients are suffering from such a disease and statistics show an acute colonic pseudo-obstruction of 0.29%. The patients that will undergo a massive procedure will have higher risks as studies show us, from 0, 65% up to 1, 3 % as normal outcome.

The main reason that this disorder will appear is still unknown today due to the spontaneous resolution of it. Some state that massive surgery will be the primary cause but there have been many cases in which the patient did not undergone one and still suffered from such an illness.

As far as doctors know, it will develop in hospitalized patients and will be linked with various surgical and medical conditions, studies showing that almost 95% of the cases with acute colonic pseudo-obstruction will be in connection with such a case but at the same time classifying the ones that are chronic as being idiopathic.

Patients will begin in showing symptoms on an average of three up to five days after their operative procedure. The common symptom that every patient will surely present will be stomach aches and it could progress and get worse. If you have just undergone a massive operative procedure and have experienced a symptom like this, you should go to your doctor as soon as you can. Other important symptoms will be nausea, constipation or severe vomiting. In a small number of patients also there has been noticed a severe case of diarrhea.

One of the most dramatic findings in a patient was massive abdominal distention. Also, patients presented fever and abnormal bowel sounds. If the diagnosis has been confirmed then the first type of treatment will be the conservative management. This will include nesogastric decompression, no oral intake, reduction or discontinuation of some drugs that can inhibit gastrointestinal motility, correction of fluid and electrolyte disorders and treatment for several infections.

Adding to this long list intermittent positive-pressure breathing may get worse and treatment should be avoided.

Other treatments will involve rectal tubes, enemas or rigid sigmoidoscopy. An important part to any treatment that will be used will be the maintenance of a bowel regimen so that it would prevent any obstipation or constipation and will improve colonic motility.

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