Ament M E, Vargas J
Division of Pediatric Gastroenterology, Hepatology and Nutrition, UCLA Medical Center 90024-1752.
Arq Gastroenterol. 1988 Jul-Sep;25(3):157-65.
Chronic intestinal pseudo-obstruction is a rare disorder characterized by ineffective intestinal propulsion in the absence of mechanical factors. It depends on isolated or associated disturbances of intrinsic and extrinsic innervation of the smooth muscle, neurotransmitters and hormones. In children the most common causes are postoperative paralytic ileus, pneumonia or pancreatitis, occurring usually in the first year of life. There is also hereditary transmission, comprising the familial visceral myopathy (hollow visceral myopathy) and the familial visceral neuropathy. The pseudo-obstruction may be associated with congenital anomalies (digestive or not) in 10 to 30% of the cases, mainly malrotation, pyloric stenosis and bladder atony. Diagnostic difficulties may lead to exploratory laparotomy. A precise diagnosis requires judicious interpretation of radiologic, manometric, radioisotopic and hystologic findings. Medical treatment includes drugs acting on gastrointestinal motility as well as hydroelectric and nutritional support, besides treatment or prevention of infections. It is possible that in the future these patients may be treated by surgical implantation of electrodes promoting gastrointestinal myoelectrical stimulation.
慢性肠道假性梗阻是一种罕见的疾病，其特征是在没有机械因素的情况下肠道推进无效。它取决于平滑肌的内在和外在神经支配、神经递质和激素的孤立或相关紊乱。在儿童中，最常见的原因是术后麻痹性肠梗阻、肺炎或胰腺炎，通常发生在生命的第一年。也有遗传传递，包括家族性内脏肌病（中空内脏肌病）和家族性内脏神经病。在10%至30%的病例中，假性梗阻可能与先天性异常（无论是否为消化系统异常）相关，主要是肠旋转不良、幽门狭窄和膀胱无力。诊断困难可能导致 exploratory laparotomy（此处原文可能有误，推测为exploratory laparoscopy，即“ exploratory laparoscopy”，意思是“ exploratory laparoscopy”，即“探索性腹腔镜检查”）。准确的诊断需要对放射学、测压、放射性同位素和组织学检查结果进行明智的解读。药物治疗包括作用于胃肠动力的药物以及水电和营养支持，此外还包括治疗或预防感染。未来这些患者有可能通过手术植入促进胃肠肌电刺激的电极进行治疗。
