Nakhgevany K B
Am J Surg. 1984 Sep;148(3):317-20. doi: 10.1016/0002-9610(84)90462-8.
Pseudoobstruction of the large bowel occurs as acute distention of the colon, usually in a high risk and seriously ill patient without any mechanical obstruction. Massive distention of the colon results in perforation of the cecum and fecal peritonitis and is associated with a very high mortality rate. Laparotomy with cecostomy is the recommended surgical therapy for this problem which carries a mortality rate of over 20 percent. We have used the colonoscope to decompress the distended colon, and especially the cecum, in 10 patients with Ogilvie's syndrome, with a 90 percent success rate and no deaths or complications. The surgeon should follow the several technical guidelines mentioned herein for successful and safe performance of the procedure. These guidelines include a tap water enema of about 1,000 ml before the procedure, avoidance of the liberal use of air insufflation during the procedure, and blind insertion of the colonoscope. This procedure is not indicated in any patient with signs of peritonitis and perforation.
大肠假性梗阻表现为结肠急性扩张，通常发生在高危且病情严重的患者身上，且不存在任何机械性梗阻。结肠的大量扩张会导致盲肠穿孔和粪性腹膜炎，其死亡率非常高。剖腹术加盲肠造口术是针对该问题推荐的手术治疗方法，其死亡率超过20%。我们使用结肠镜对10例奥吉尔维综合征患者扩张的结肠，尤其是盲肠进行减压，成功率达90%，且无死亡或并发症发生。外科医生应遵循本文提及的若干技术指南，以成功、安全地实施该手术。这些指南包括术前约1000毫升的自来水灌肠、术中避免过度使用空气充气以及结肠镜的盲目插入。该手术不适用于任何有腹膜炎和穿孔迹象的患者。
