Acute colonic pseudo-obstruction: A case series and literature review

Abstract

Acute colonic pseudo-obstruction (ACPO) is an obstructive phenomenon of functional origin characterized by pain and acute colonic dilatation in the absence of a mechanical cause. It primarily affects patients with several comorbidities, postoperative patients, and/or critically ill patients. The most widely accepted pathophysiologic theory is enteric autonomic dysfunction. Diagnosis must be confirmed through abdominal tomography, ruling out causes of mechanical obstruction and revealing complications, such as ischemia and/or bowel perforation. Treatment is stepped, taking symptom severity, cecal diameter, hemodynamic stability, and/or the presence of complications into account. It is started with conservative measures, and in cases with partial response or refractoriness, there are pharmacologic, endoscopic, and surgical therapeutic options. The aim of this article is to describe four cases of patients diagnosed with ACPO treated at a tertiary care hospital.