Gillies Maddi, AlDujaili Thair
General Surgery, Goulburn Valley Health, Shepparton, AUS.
Cureus. 2023 Feb 7;15(2):e34756. doi: 10.7759/cureus.34756. eCollection 2023 Feb.
Acute colonic pseudo-obstruction (ACPO) is obstruction of the large bowel without a mechanical cause. The exact mechanism remains incompletely understood but is thought to result from disruption to the autonomic regulation of the colon, typically in the context of hospitalized patients with medical illness, precipitating medications, or recent surgical intervention. This paper presents an unusual case of ACPO in an ambulatory patient with a recently passed renal calculus, explores the anatomy and physiology underlying the autonomic dysfunction theory of ACPO pathogenesis in the context of the case, and provides a 3D reconstruction of the patient's CT to illustrate the abrupt caliber change at the splenic flexure characteristic of ACPO.
急性结肠假性梗阻(ACPO)是指无机械性病因的大肠梗阻。其确切机制仍未完全明确,但一般认为是由于结肠自主神经调节功能紊乱所致,通常发生在患有内科疾病、正在服用某些促发药物或近期接受过外科手术的住院患者身上。本文介绍了一例门诊患者发生的不寻常的ACPO病例,该患者近期有肾结石排出。结合此病例探讨了ACPO发病机制中自主神经功能障碍理论的解剖学和生理学基础,并提供了患者CT的三维重建图像,以说明ACPO特征性的脾曲处肠腔口径突然改变的情况。