Zhu Chang-Zhen, Zhao Hong-Wei, Lin Hong-Wei, Wang Feng, Li Yuan-Xin
Department of Gastrointestinal Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
World J Clin Cases. 2020 Dec 6;8(23):5852-5865. doi: 10.12998/wjcc.v8.i23.5852.
Chronic intestinal pseudo-obstruction (CIPO) is a type of intestinal dysfunction presenting as symptoms of intestinal obstruction but without actual mechanical obstruction. An extremely low incidence, non-specific clinical symptoms, strong heterogeneity, and no definitive cause in some patients make CIPO very difficult to diagnose correctly. Imaging and gastrointestinal manometry are commonly used. Most patients have progressive worsening of their symptoms and require intervention, and nutritional assessment and treatment are very important to determine the prognosis. With improvements in surgical techniques, small bowel transplantation is a feasible treatment option for patients with advanced CIPO; however, the long-term prognosis for CIPO patients remains unsatisfactory. Generally, the disease is rare and difficult to diagnose, which leads to clinicians' lack of understanding of the disease and results in a high rate of misdiagnosis. This review describes the characteristics of CIPO and the latest developments in diagnosis and treatment, in detail. The goal of our review is to improve clinicians' understanding of CIPO so that the disease is identified quickly and accurately, and treated as early as possible to improve patients' quality of life.
慢性假性肠梗阻(CIPO)是一种肠道功能障碍,表现为肠梗阻症状,但无实际机械性梗阻。发病率极低、临床症状不具特异性、异质性强且部分患者病因不明,使得CIPO很难正确诊断。常用的检查方法是影像学检查和胃肠测压。大多数患者症状会进行性加重,需要干预治疗,营养评估和治疗对判断预后非常重要。随着外科技术的进步,小肠移植是晚期CIPO患者可行的治疗选择;然而,CIPO患者的长期预后仍不尽人意。一般来说,该病罕见且难以诊断,导致临床医生对其认识不足,误诊率较高。本综述详细描述了CIPO的特点以及诊断和治疗的最新进展。我们综述的目的是提高临床医生对CIPO的认识,以便能快速准确地识别该病,并尽早治疗以提高患者的生活质量。