Gawel Richard J, Zhang Qian, Boigon Margot I
Internal Medicine, Abington Hospital, Abington, USA.
Cureus. 2022 Nov 30;14(11):e32079. doi: 10.7759/cureus.32079. eCollection 2022 Nov.
Acute colonic pseudo-obstruction (ACPO) is a rare cause of massive colonic dilation without mechanical obstruction. We report on a 58-year-old gentleman who developed two separate episodes of ACPO following different surgical and medical stressors. The initial episode occurred shortly after lumbar laminectomy and was successfully managed with medical therapy. His second episode occurred several months later in the setting of acute hypoxic respiratory failure secondary to bacterial pneumonia and was refractory to conservative, medical, and endoscopic therapy. Recurrence and the refractory nature of symptoms are presumably multifactorial in etiology, likely due to his episode of acute hypoxic respiratory failure in the setting of chronic immobility following recent spine surgery. The patient was discharged in stable condition to a subacute rehabilitation facility with the expectation that physical therapy would improve his abdominal symptoms.
急性结肠假性梗阻（ACPO）是导致结肠大量扩张但无机械性梗阻的罕见原因。我们报告一位58岁男性，在经历不同的手术和医疗应激源后发生了两次独立的ACPO发作。首次发作发生在腰椎椎板切除术后不久，通过药物治疗成功处理。他的第二次发作发生在数月后，继发于细菌性肺炎的急性低氧性呼吸衰竭背景下，对保守治疗、药物治疗和内镜治疗均无效。症状的复发和难治性可能病因是多因素的，可能归因于他近期脊柱手术后长期制动情况下发生的急性低氧性呼吸衰竭。患者出院时病情稳定，前往亚急性康复机构，期望物理治疗能改善他的腹部症状。
