Saunders Michael D
Division of Gastroenterology, University of Washington Medical Center, 1959 Northeast Pacific Avenue, Suite AA103P, Box 356424, Seattle, WA 98195, USA.
Gastrointest Endosc Clin N Am. 2007 Apr;17(2):341-60, vi-vii. doi: 10.1016/j.giec.2007.03.007.
Acute colonic pseudo-obstruction (ACPO) is a syndrome of massive dilation of the colon without mechanical obstruction that develops in hospitalized patients with serious underlying medical and surgical conditions. Increasing age, cecal diameter, delay in decompression, and status of the bowel significantly influence mortality, which is approximately 40% when ischemia or perforation is present. Evaluation of the markedly distended colon involves excluding mechanical obstruction and other causes of toxic megacolon such as Clostridium difficile infection and assessing for signs of ischemia and perforation. The risk of colonic perforation in ACPO increases when cecal diameter exceeds 12 cm and when the distention has been present for greater than 6 days. Appropriate management includes supportive therapy and selective use of neostigmine and colonoscopy for decompression. Early recognition and management are critical in minimizing complications.
急性结肠假性梗阻（ACPO）是一种结肠无机械性梗阻却发生大量扩张的综合征，多见于患有严重基础内科及外科疾病的住院患者。年龄增长、盲肠直径增大、减压延迟以及肠道状态均会显著影响死亡率，出现缺血或穿孔时死亡率约为40%。对明显扩张的结肠进行评估时，需排除机械性梗阻以及其他导致中毒性巨结肠的原因，如艰难梭菌感染，并评估有无缺血和穿孔迹象。当盲肠直径超过12 cm以及扩张持续超过6天时，ACPO患者发生结肠穿孔的风险会增加。恰当的处理措施包括支持治疗以及选择性使用新斯的明和结肠镜进行减压。早期识别和处理对于将并发症降至最低至关重要。
