Acute pseudo-obstruction of the colon.

Nineteen patients presenting with pseudo-obstruction of the colon are described. Thirteen were female and the mean age was 65.7 years (48-82). Five cases appeared idiopathic but the remainder were associated with either intercurrent disease, surgery or trauma. Six patients underwent laparotomy, 3 for gross caecal distension and 1 subsequently died with bronchopneumonia. Thirteen patients were treated conservatively with flatus tube decompression or colonoscopy, but 3 died, 1 from a perforated caecum, 1 from a recurrent subarachnoid haemorrhage and 1 from bronchopneumonia. The high mortality of caecal perforation in this condition is stressed, and gross radiological caecal distension with overlying tenderness is an indication for urgent decompression.