Gilchrist A M, Mills J O, Russell C G
Clin Radiol. 1985 Jul;36(4):401-4. doi: 10.1016/s0009-9260(85)80317-2.
The clinical and radiological features of acute large-bowel pseudo-obstruction occurring in 13 patients over a 7-year period are reviewed. Clinical features included atypical signs and symptoms of large-bowel obstruction and serious concomitant illness, including trauma in 10. The predominant radiological features were gross colonic dilatation, scant fluid levels, a gradual transition to collapsed bowel and a normal gas and faecal pattern in the rectum. Correct diagnosis was established by plain film and/or barium enema examination in the majority of cases (nine out of the 13). In the remaining four cases the diagnosis was made at laparotomy, although review of the radiographs suggested that the correct diagnosis could have been made pre-operatively in three. Instant barium enema is recommended in doubtful cases to rule out distal obstruction. Prompt recognition of the condition, with daily monitoring and conservative management, should eliminate unnecessary surgery and minimise the risk of caecal perforation.
回顾了7年间13例急性大肠假性梗阻患者的临床和放射学特征。临床特征包括大肠梗阻的非典型体征和症状以及严重的伴随疾病，其中10例有创伤史。主要的放射学特征为结肠显著扩张、液平较少、逐渐过渡到肠管塌陷以及直肠内正常的气体和粪便形态。大多数病例（13例中的9例）通过平片和/或钡剂灌肠检查得以确诊。其余4例在剖腹手术时确诊，不过回顾X线片显示其中3例本可在术前做出正确诊断。对于可疑病例，建议立即进行钡剂灌肠以排除远端梗阻。及时识别病情，每日监测并采取保守治疗，应可避免不必要的手术并将盲肠穿孔风险降至最低。
