Helpap B, Holna J
Chirurg. 1986 Jan;57(1):31-4.
The pseudoobstruction corresponds to the condition of an extreme colonic dilatation with possible wall perforation without concrete evidence of a real block. Acute, reversible and chronic types are distinguished. On two examples, clinic and pathology (through autopsy) are extensively described and discussed with literature. The highest risk in acute pseudoobstruction is a wall perforation with stercoral peritonitis. This is mostly fatal. When diagnosed in time, trials of decompression are indicated. The acute pseudoobstruction is mostly observed in traumatic and septic conditions, but also with extreme alcohol abuse and consuming tumorous diseases. Chronic courses of the diseases are often associated with Parkinsonism. In this form of pseudoobstruction, functional disorders of the smooth musculature appear to be present. Electrolyte disorders are to be regarded as consecutive conditions. The mean age is 61 years. There is a slight predominance of the male sex. The cases presented were combined with chronic-granulomatous necrotizing osteomyelitis and lung carcinomas in the acute form, with Parkinsonism in the chronic form, thus corresponding to literature. Altogether this is a rare disease with a frequency about 1 out of 10000 to 15000 patients admitted to surgical departments.
假性肠梗阻是指结肠极度扩张,可能伴有肠壁穿孔,但无确凿的真正梗阻证据的一种病症。可分为急性、可逆性和慢性三种类型。本文通过两个病例,结合文献对其临床症状和病理表现(通过尸检)进行了详细描述和讨论。急性假性肠梗阻的最大风险是肠壁穿孔伴粪性腹膜炎,这通常是致命的。若能及时诊断,可尝试进行减压治疗。急性假性肠梗阻多见于创伤和感染性疾病,也可见于极度酗酒和患有肿瘤性疾病的患者。慢性病程常与帕金森病相关。在这种假性肠梗阻形式中,似乎存在平滑肌的功能障碍。电解质紊乱应视为继发性病症。平均年龄为61岁,男性略占多数。本文所呈现的病例,急性形式合并慢性肉芽肿性坏死性骨髓炎和肺癌,慢性形式合并帕金森病,与文献报道相符。总体而言,这是一种罕见疾病,在外科住院患者中发病率约为万分之一至万分之一点五。