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Chenyan Zhao, Tingbin Xie, Jun Li, Minhua Cheng, Jialiang Shi, Tao Gao, Fengchan Xi, Juanhong Shen, Chun Cao, Wenkui Yu
Objective. To compare the differences between acute colonic pseudo-obstruction (ACPO) with and without acute gut wall thickening. Methods. ACPO patients with feeding tolerance were divided into ACPO with no obvious gut wall thickening (ACPO-NT) group and ACPO with obvious acute gut wall thickening (ACPO-T) group according to computed tomography and abdominal radiographs. Patients' condition, responses to supportive measures, pharmacologic therapy, endoscopic decompression, and surgeries and outcomes were compared...
2017: Gastroenterology Research and Practice
Michael Patrick Turner, Sophie Arndtz, George MacFaul
A 61-year-old man presented with accumulation of ascites secondary to alcoholic liver disease. He had an ascitic drain sited and 24 hours later he developed acute colonic pseudo-obstruction (ACPO). This is a rare condition previously associated with major surgery and severe sepsis. The patient did well with conservative management, and avoided the need for endoscopic decompression or surgical intervention. We believe that this is the first report of ACPO secondary to abdominal paracentesis.
January 9, 2017: BMJ Case Reports
Jeung Hui Pyo, Yang Won Min, Poong-Lyul Rhee
Neostigmine can successfully decompress patients with acute colonic pseudo-obstruction (ACPO) who are unresponsive to conservative therapy. However, neostigmine is contraindicated in renal failure, so it is underused in ACPO patients with renal failure who would be otherwise appropriate candidates. We described the first successfully treated case of acute kidney injury (AKI) with neostigmine in a patient with ACPO. A 72-year-old man who underwent a coronary artery bypass graft surgery 11 days prior presented to the emergency room with abdominal distension, peripheral edema, and dyspnea on exertion...
February 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
David Newnham
The official-looking email was rather alarming. Glancing at the sender's name, I saw it was from ACPO - the Association of Chief Police Officers. Was I in trouble?
February 24, 2016: Nursing Standard
Samuel W Ross, Bindhu Oommen, Blair A Wormer, Amanda L Walters, Vedra A Augenstein, B Todd Heniford, Ronald F Sing, A Britton Christmas
Acute colonic pseudo-obstruction (ACPO) is a rare but often fatal disease. Herein, we present the largest study to date on ACPO. The National Inpatient Sample was queried for ACPO diagnoses from 1998 to 2011. Patients were analyzed by treatment into four groups: medical management (MM), colonoscopy alone [(endoscopy-only group) ENDO], surgery alone (SURG), or surgery and colonoscopy (SAC). Logistic regression was used to identify predictors of adverse outcomes by treatment group. There were 106,784 cases of ACPO: 96,657 (90...
February 2016: American Surgeon
J W G Ng, S A Cairns, C P O'Boyle
BACKGROUND: Burn produces complex gastrointestinal (GI) responses. Treatment, including large volume fluid resuscitation and opioid analgesia, may exacerbate GI dysfunction. Complications include constipation and opioid-induced bowel dysfunction (OBD), acute colonic pseudo-obstruction (ACPO), bacterial translocation and sepsis, and abdominal compartment syndrome (ACS). Contamination of perineal burns contributes to delayed healing, skin graft failure and sepsis and may impact upon morbidity and mortality...
June 2016: Burns: Journal of the International Society for Burn Injuries
Monique Cebola, Eliza Eddy, Suzanne Davis, Laura Chin-Lenn
Rapid identification of acute colonic pseudo-obstruction (ACPO), or Ogilvie's syndrome, is paramount in the management of this condition, which, if unresolved, can progress to bowel ischemia and perforation with significant morbidity and mortality. We present the first case report, to our knowledge, of ACPO following total laparoscopic hysterectomy. We describe the presentation and management of ACPO in a patient who underwent uncomplicated total laparoscopic hysterectomy to treat menorrhagia and dysmenorrhea after declining conservative treatment...
November 2015: Journal of Minimally Invasive Gynecology
Michael Reeves, Frank Frizelle, Christopher Wakeman, Catherine Parker
BACKGROUND: Acute colonic pseudo-obstruction is an uncommon but potentially morbid complication of pregnancy. The aim of the study was to review a single institution's experience with acute colonic pseudo-obstruction in post-partum patients and develop an algorithm for management based on a literature review. METHODS: This is a retrospective study where patients were identified over a 2-year period (1 December 2012 to 31 November 2014) by checking all deliveries in Christchurch Women's Hospital against diagnosis codes for bowel obstruction and ileus...
October 2015: ANZ Journal of Surgery
Allen P Chudzinski, Earl V Thompson, Jennifer M Ayscue
Acute colonic pseudoobstruction (ACPO), often referred to as Ogilvie syndrome, is a clinical entity characterized by severe colonic distension (adult acute megacolon) in the absence of mechanical obstruction. It can result in abdominal ischemia and perforation if left untreated. This article discusses the epidemiology and current pathophysiologic theories of ACPO as well as the clinical presentation and diagnostic modalities utilized to identify the disease. In addition, this article describes the current treatment options for ACPO, which range from conservative medical therapy, therapeutic endoscopy, to subtotal colectomy...
June 2015: Clinics in Colon and Rectal Surgery
Tracy Jaffe, William M Thompson
Large-bowel obstruction is an abdominal emergency with high morbidity and mortality rates if left untreated. Although abdominal radiography is usually the initial imaging study performed in patients suspected of having large-bowel obstruction, it may not be sufficient to distinguish obstruction from other causes of colonic dilatation. Computed tomography is the imaging method of choice as it can establish the diagnosis and cause of large-bowel obstruction. A contrast agent enema may be used to confirm or exclude large-bowel obstruction...
June 2015: Radiology
Maria-Pia Bernardi, Satish Warrier, A Craig Lynch, Alexander G Heriot
Acute colonic pseudo-obstruction (ACPO) and chronic intestinal pseudo-obstruction (CIPO) are distinct clinical entities in which patients present similarly with symptoms of a mechanical obstruction without an occlusive lesion. Unfortunately, they also share the issues related to a delay in diagnosis, including inappropriate management and poor outcomes. Advancements have been made in our understanding of the aetiologies of both conditions. Several predisposing factors linked to critical illness have been implicated in ACPO...
October 2015: ANZ Journal of Surgery
S Müller-Lissner
The motility of the colon is modulated by the enteric nervous system. It is very complex, governing backward and forward movements of the feces. Primary megacolon and megarectum are clinically diverse. Megacolon refractory to laxative treatment may be subject to colectomy, while megarectum should be treated by consistent laxation. Acute colonic pseudo-obstruction may occur with severe systemic diseases and electrolyte disturbances or it may be postoperatively and/or medically induced. A small proportion of chronically constipated patients suffer from slow transit constipation, others from disordered defecation...
June 2015: Der Internist
F Begbie, G Walker, H Kubba, A Sabharwal
Colonic pseudo-obstruction (Ogilvie's Syndrome) in children is relatively uncommon. We report an unusual case of colonic pseudo-obstruction in an 8-year-old child with cerebral palsy and long-term hypomotility issues being treated for drooling with the anticholinergic medication trihexyphenidyl. He presented as an emergency with severe abdominal distension, abdominal tenderness and vomiting. An emergency laparotomy revealed colonic dilatation and a defunctioning ileostomy was created. To our knowledge, this is the first case reporting colonic pseudo-obstruction as a possible complication of treatment with trihexyphenidyl...
June 2015: International Journal of Pediatric Otorhinolaryngology
P Pereira, F Djeudji, P Leduc, F Fanget, X Barth
Ogilvie's syndrome describes an acute colonic pseudo-obstruction (ACPO) consisting of dilatation of part or all of the colon and rectum without intrinsic or extrinsic mechanical obstruction. It often occurs in debilitated patients. Its pathophysiology is still poorly understood. Since computed tomography (CT) often reveals a sharp transition or "cut-off" between dilated and non-dilated bowel, the possibility of organic colonic obstruction must be excluded. If there are no criteria of gravity, initial treatment should be conservative or pharmacologic using neostigmine; decompression of colonic gas is also a favored treatment in the decision tree, especially when cecal dilatation reaches dimensions that are considered at high risk for perforation...
April 2015: Journal of Visceral Surgery
Kerem Karaman, Alpaslan Tanoglu, Yavuz Beyazit, Ismet Han
Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome, is a clinical syndrome characterised by gross dilation of the caecum and right hemicolon, which sometimes extends to the sigmoid colon and rectum in the absence of an anatomic lesion in the intestinal lumen. It is characterised by impaired propulsion of contents of the gastrointestinal tract, which results in a clinical picture of intestinal obstruction. A careful examination of the markedly distended colon can exclude several colonic pathologies, including mechanical obstruction and other causes of toxic megacolon...
February 25, 2015: BMJ Case Reports
Fares Alahdab, Shreyas Saligram
A 70-year-old woman with end-stage liver disease from hepatitis C was admitted to the hospital for confusion. Portosystemic encephalopathy was diagnosed, and the patient was treated with 20 g of lactulose every 6 hours. A few days after admission, abdominal pain with marked abdominal distention..
January 22, 2015: New England Journal of Medicine
Raul Guillermo Lopez Valle, Francisco Lopez Godoy
INTRODUCTION: Acute colonic pseudo-obstruction (ACPO) is an uncommon condition that occasionally develops in hospitalized patients with serious underlying ailments. Its early recognition is essential to reduce life-threatening complications. Few low-powered randomized clinical trials (RCTs) have confirmed the effectiveness of neostigmine for treatment. AIM: To analyse the effectiveness and main side effects of neostigmine in the treatment of ACPO. EXPERIMENTAL: A literature search was performed for all published RCTs, reporting on neostigmine as treatment for ACPO...
September 2014: Annals of Medicine and Surgery
Shintaro Nakano, Takatoshi Kasai, Jun Tanno, Keiki Sugi, Yasumasa Sekine, Toshihiro Muramatsu, Takaaki Senbonmatsu, Shigeyuki Nishimura
BACKGROUND: Adaptive servo-ventilation has a potential sympathoinhibitory effect in acute cardiogenic pulmonary oedema (ACPO). AIMS: To evaluate the acute effects of adaptive servo-ventilation in patients with ACPO. METHODS: Fifty-eight consecutive patients with ACPO were divided into those who underwent adaptive servo-ventilation and those who received oxygen therapy alone as part of their immediate care. Visual analogue scale, vital signs, blood gas data and plasma catecholamine concentrations at baseline and 1 h during emergency care, and subsequent clinical events (death within 30 days, intubation within seven days or between seven and 30 days, and length of hospital stay) were assessed...
August 2015: European Heart Journal. Acute Cardiovascular Care
T Rauer, J Sproedt, H Gelpke, A R Jandali
We report a case of a 62 year old woman who presented with Ogilvie's syndrome as a complication of mastectomy with free TRAM flap reconstruction due to angiosarcoma of the right breast. In the acute postoperative period, the patient expired as a result of Ogilvie's syndrome related complications. Several assumptions regarding the causes of Ogilvie's Syndrome as well as current theories about aetiology, diagnosis and therapy are discussed in this case presentation.
August 2014: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Kristopher G Hooten, Seth F Oliveria, Shawn D Larson, David W Pincus
Ogilvie's syndrome is a rare and potentially fatal disease that can easily be mistaken for postoperative ileus. Also known as acute colonic pseudo-obstruction, early recognition and diagnosis of the syndrome allows for treatment prior to bowel perforation and requisite abdominal surgery. The authors report a case of Ogilvie's syndrome following spinal deformity correction and tethered cord release in an adolescent who presented with acute abdominal distension, nausea, and vomiting on postoperative Day 0. The patient was initially diagnosed with adynamic ileus and treated conservatively with bowel rest, reduction in narcotic dosage, and a regimen of stool softeners, laxatives, and enemas...
September 2014: Journal of Neurosurgery. Pediatrics
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