Melzig E P, Terz J J
Arch Surg. 1978 Oct;113(10):1186-90. doi: 10.1001/archsurg.1978.01370220072012.
Psuedo-obstruction of the colon is a potentially lethal condition. The diagnosis should be suspected in a patient with derangement of a major extra-abdominal organ system in whom abdominal distention develops. Diagnosis is established by plain abdominal roentgenograms, signoidoscopy, and barium enema examination. The salient features of these examinations are as follows: (1) massive gaseous distention of the cecum and variable distances of the distal colon to a "cut-off-point"; (2) lack of fluid-filled colon; (3) normal sigmoidoscopy; and (4) barium enema examination, which rules out mechanical obstruction, volvulus, and mesenteric vascular ischemia. If the diameter of the cecum is less than 12 cm, conservative therapy is indicated but persistence of the distention or cecal diameter greater than 12 cm is an absolute indication for cecostomy. Perforation must be treated by cecostomy or colectomy depending on the amount of colon necrosis.
结肠假性梗阻是一种可能致命的疾病。对于主要腹外器官系统紊乱且出现腹胀的患者，应怀疑该病。通过腹部平片、乙状结肠镜检查和钡剂灌肠检查来确诊。这些检查的显著特征如下：（1）盲肠大量气体扩张，远端结肠至“截断点”的距离不等；（2）无充满液体的结肠；（3）乙状结肠镜检查正常；（4）钡剂灌肠检查可排除机械性梗阻、肠扭转和肠系膜血管缺血。如果盲肠直径小于12厘米，可采取保守治疗，但腹胀持续或盲肠直径大于12厘米则绝对指征为行盲肠造口术。根据结肠坏死的程度，穿孔必须通过盲肠造口术或结肠切除术进行治疗。
