Department of Clinical Medicine and Surgery, Washington University School of Medicine, St. Louis, MO, USA.
J Clin Gastroenterol. 2011 Nov-Dec;45(10):883-4. doi: 10.1097/MCG.0b013e31821100ab.
Acute colonic pseudo-obstruction (ACPO) or Ogilvie syndrome is an idiopathic syndrome of dilation of the colon without mechanical obstruction that develops in hospitalized patients usually in the setting of significant medical and surgical conditions. Standard care therapy includes colonoscopic decompression or neostigmine. The latter is not Food and Drug Administration-approved for this indication but has been the recent intervention of choice. A patient with ACPO failed 2 injections of neostigmine. A clinical trial of subcutaneous methylnaltrexone was administered because she was on opioid therapy. There was a brisk response to methylnaltrexone, a μ-opioid-receptor antagonist which does not cross the blood-brain barrier. This is the first case report in the literature and in the pharmaceutical company's data bank that illustrates a potential role for methylnaltrexone in ACPO. Prospective, larger studies to determine the role of methylnaltrexone in ACPO are warranted.
急性结肠假性梗阻（ACPO）或奥格尔维综合征是一种特发性结肠扩张综合征，无机械性梗阻，在住院患者中通常发生在重大医疗和外科条件下。标准治疗包括结肠镜减压或新斯的明。后者未经食品和药物管理局批准用于该适应症，但最近已成为首选干预措施。一名 ACPO 患者新斯的明注射 2 次失败。由于她正在接受阿片类药物治疗，因此进行了皮下美沙酮的临床试验。美沙酮是一种 μ-阿片受体拮抗剂，不会穿过血脑屏障，对其反应迅速。这是文献和制药公司数据库中首例报告，表明美沙酮在 ACPO 中的潜在作用。需要进行前瞻性、更大规模的研究来确定美沙酮在 ACPO 中的作用。
