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慢性假性肠梗阻的最新进展。

Update on chronic intestinal pseudo-obstruction.

机构信息

Emergency Pediatric Department, Santobono-Pausilipon Children's Hospital, Naples.

Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome.

出版信息

Curr Opin Gastroenterol. 2020 May;36(3):230-237. doi: 10.1097/MOG.0000000000000630.

Abstract

PURPOSE OF REVIEW

Chronic intestinal pseudo-obstruction (CIPO) is the most severe and disabling form of gastrointestinal dysmotility characterized by an impairment of coordinated propulsive activity in the gastrointestinal tract mimicking mechanical intestinal obstruction. Over the last few years, major advances have been made in the diagnostic and therapeutic management of this rare disorder.

RECENT FINDINGS

The present narrative review aims to summarize the current literature about the management of CIPO focusing on significant novelties about definition, epidemiology, diagnosis, and therapeutic options. The most significant advancement is a consensus on classification and dedicated diagnostic criteria for CIPO in children highlighting the distinctive features between adult and pediatric forms of CIPO (hence pediatric intestinal pseudo-obstruction). Despite no single diagnostic test is pathognomonic of CIPO and no recommended drug treatment is advised to improve gastrointestinal motility, recent reports suggest promising results in both diagnostic testing and therapy that might assist the diagnosis and help the management of patients with CIPO.

SUMMARY

The articles referenced in this review will help in optimizing the clinical management of this rare and severe disease in adult population.

摘要

目的综述

慢性肠假性梗阻(CIPO)是胃肠道动力障碍最严重和致残的形式,其特征为胃肠道协调推进活动受损,类似于机械性肠梗阻。在过去的几年中,对这种罕见疾病的诊断和治疗管理取得了重大进展。

最近的发现

本综述旨在总结目前关于 CIPO 管理的文献,重点介绍关于定义、流行病学、诊断和治疗选择的重要新进展。最大的进步是就 CIPO 的分类和专门诊断标准达成共识,强调了成人和儿科形式的 CIPO 之间的显著特征(因此为小儿肠假性梗阻)。尽管没有单一的诊断测试是 CIPO 的特征性表现,也没有推荐药物治疗来改善胃肠道动力,但最近的报告表明,在诊断测试和治疗方面都有有希望的结果,这可能有助于 CIPO 患者的诊断和治疗。

总结

本文综述中引用的文章将有助于优化成人中这种罕见且严重疾病的临床管理。

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