La Revue de medecine interne · 2001
[Acute colonic pseudo-obstruction in internal medicine: etiology and prognosis, report of a retrospective study].
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Rondeau M, Weber J C, Nodot I, Storck D
Аннотация
PURPOSE: To analyze the context in which acute colonic pseudo-obstructions occur in a medical practice.
METHOD: Retrospective study of patients with an acute colonic pseudo-obstruction hospitalized in an internal medicine department between November 1992 and December 1999.
RESULTS: We found 12 patients including eight men (mean age: 80.2 years). All had abdominal pains. Seven patients presented an occlusive syndrome. A septic shock occurred in two subjects. The average diameter of the cecum was 10 cm. Distention involved the whole colon for nine patients, and only the left part for three. Six subjects were affected by a bronchopneumonia, three had a previous history of recent diarrhea, two had colonic diverticulitis, and two others had a diabetic neuropathy. Ogilvie's syndrome revealed hypothyroidism for one patient. Nine patients were taking one or more medications incriminated in the acute colonic pseudo-obstruction: calcium-channel blockers (n = 6), neuroleptics (n = 5), antidepressant agents (n = 4), dopaminergic drugs (n = 2) and opiates (n = 1). Five patients underwent a colonoscopic decompression. Surgical procedures were undertaken for three patients: one underwent a complete colectomy because of numerous perforation. Except for the colectomized patient, the outcome resulted in either recovery (n = 7), partial improvement (n = 3), or recurrence (n = 1).
CONCLUSION: In a medical environment, acute colonic pseudo-obstruction is a pathology for elderly persons, namely with a masculine predominance and often associated with iatrogenic factors. The outcome is more often than not favorable, but it may result in invasive acts or significant complications at this age.
METHOD: Retrospective study of patients with an acute colonic pseudo-obstruction hospitalized in an internal medicine department between November 1992 and December 1999.
RESULTS: We found 12 patients including eight men (mean age: 80.2 years). All had abdominal pains. Seven patients presented an occlusive syndrome. A septic shock occurred in two subjects. The average diameter of the cecum was 10 cm. Distention involved the whole colon for nine patients, and only the left part for three. Six subjects were affected by a bronchopneumonia, three had a previous history of recent diarrhea, two had colonic diverticulitis, and two others had a diabetic neuropathy. Ogilvie's syndrome revealed hypothyroidism for one patient. Nine patients were taking one or more medications incriminated in the acute colonic pseudo-obstruction: calcium-channel blockers (n = 6), neuroleptics (n = 5), antidepressant agents (n = 4), dopaminergic drugs (n = 2) and opiates (n = 1). Five patients underwent a colonoscopic decompression. Surgical procedures were undertaken for three patients: one underwent a complete colectomy because of numerous perforation. Except for the colectomized patient, the outcome resulted in either recovery (n = 7), partial improvement (n = 3), or recurrence (n = 1).
CONCLUSION: In a medical environment, acute colonic pseudo-obstruction is a pathology for elderly persons, namely with a masculine predominance and often associated with iatrogenic factors. The outcome is more often than not favorable, but it may result in invasive acts or significant complications at this age.