TAILIEUCHUNG - Cooney and Cooney International Journal of Emergency Medicine 2011, 4:15

Cooney and Cooney International Journal of Emergency Medicine 2011, 4:15 CASE REPORT Open Access Massive acute colonic pseudo-obstruction successfully managed with conservative therapy in a patient with cerebral palsy Derek R Cooney* and Norma L Cooney Abstract Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie syndrome, is a massive dilation of the colon in the absence of mechanical obstruction. Treatment measures may include anticholinergic agents such as neostigmine, colonoscopy, or fluoroscopic decompression, surgical decompression, and partial or complete colectomy. We reviewed the case of a 26-year-old male with cerebral palsy who had a history of chronic intermittent constipation who presented to the emergency department. | Cooney and Cooney International Journal of Emergency Medicine 2011 4 15 http content 4 1 15 o International Journal of Emergency Medicine a SpringerOpen Journal CASE REPORT Open Access Massive acute colonic pseudo-obstruction successfully managed with conservative therapy in a patient with cerebral palsy Derek R Cooney and Norma L Cooney Abstract Acute colonic pseudo-obstruction ACPO also known as Ogilvie syndrome is a massive dilation of the colon in the absence of mechanical obstruction. Treatment measures may include anticholinergic agents such as neostigmine colonoscopy or fluoroscopic decompression surgical decompression and partial or complete colectomy. We reviewed the case of a 26-year-old male with cerebral palsy who had a history of chronic intermittent constipation who presented to the emergency department ED with signs of impaction despite recurrent fleet enemas and oral polyethylene glycol 3350. The patient was found to have a massive colonic distention of 26 cm likely because of bowel dysmotility consistent with ACPO. This article includes a discussion of the literature and images that represent clinical examination x-ray and computed tomography CT findings of this patient who successfully underwent conservative management only. Emergency department detection of this condition is important and early intervention may prevent surgical intervention and associated complications. Background Acute colonic pseudo-obstruction ACPO also known as Ogilvie syndrome or acute colonic ileus is a serious condition that can be relatively easily misdiagnosed and a patient s presentation ascribed to both minor conditions such as functional constipation and major conditions like mechanical bowel obstruction. It is important for the emergency physician to be familiar with this entity and its management in order to avoid unnecessary morbidity in these cases. Acute colonic pseudo-obstruction is a distention of the colon caused by decreased motility in the .

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