Colonoscopic Decompression of Acute Pseudo-obstruction of the Colon

Abstract

The recent advances in technology have made it possible to decompress acute pseudoobstruction of the colon with colonoscope instead of celiotomy and cecostomy. Twenty-two patients who developed acute pseudoobstruction of the colon and underwent colonoscopy were analyzed. The dilated colon was successfully, completely or partially decompressed. There were no complications. Acute pseudoobstruction of the colon is usually secondary to intra- or extraabdominal insult resulting in direct or reflex derangement of the sacral parasympathetic outflow. This causes a functional obstruction of the left colon. The goal of management is to prevent colonic perforation while treating the primary problems. Once the diagnosis has been made, colonoscopy should be attempted. Celiotomy should be reserved for cases in which colonoscopy is unsuccessful or in cases with perforations or impending perforations.