Fazel Ali, Verne G Nicholas
Department of Gastroenterology and Hepatology, University of Florida, Gainesville, FL, USA.
J Clin Gastroenterol. 2005 Jan;39(1):17-20.
Acute colonic pseudo-obstruction remains a serious medical disorder, carrying a mortality rate of 15%. It occurs in the setting of a wide variety of medical and surgical illnesses. The suspected pathogenesis consists of an autonomic imbalance resulting from decreased parasympathetic tone or excessive sympathetic output. Patients typically present with abdominal distension, pain, and altered bowel movements. Progression of disease can lead to colonic ischemia and perforation. The diagnostic evaluation excludes mechanical obstruction, toxic megacolon, perforation, and ischemia. Initial treatment most often consists of conservative measures that are followed by intravenous neostigmine when the patient fails to improve. When colonic distension persists, decompression colonoscopy is preformed. Occasionally, these measures fail necessitating surgical intervention.
急性结肠假性梗阻仍然是一种严重的医学病症，死亡率为15%。它发生在多种内科和外科疾病的背景下。推测的发病机制是由副交感神经张力降低或交感神经输出过多导致的自主神经失衡。患者通常表现为腹胀、疼痛和排便习惯改变。疾病进展可导致结肠缺血和穿孔。诊断评估排除机械性梗阻、中毒性巨结肠、穿孔和缺血。初始治疗通常包括保守措施，当患者病情无改善时，随后给予静脉注射新斯的明。当结肠扩张持续存在时，进行减压结肠镜检查。偶尔，这些措施失败，需要进行手术干预。
