Pseudo-obstruction Flashcards Preview

Year 3 Lower GI Surgery > Pseudo-obstruction > Flashcards

Flashcards in Pseudo-obstruction Deck (6)
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1

Pseudo-obstruction

Acute dilatation of the colon in the absence of a mechanical obstruction

- interruption of the ANS in colon
- absence of smooth muscle action

2

Causes

Electrolyte imbalance or endocrine disorders:
- hypercalcaemia
- hypothyroidism
- hypomagnesaemia

Medication:
- opioids
- CCBs
- anti-depressants

Recent surgery severe illness, or trauma


Neurological disease:
- Parkinson’s disease
- Multiple Sclerosis
- Hirschsprung’s disease

3

Complications

Toxic megacolon

Bowel ischaemia

Perforation

4

Clinical features

Abdominal pain

Abdominal distension

Constipation

Vomiting - late feature

Often soft and non - tender abdomen

5

Investigations

Bloods including
- Ca2+
- Mg 2+
- TFTs

AXR - bowel distention

abdominal-pelvis CT scan with IV contrast - Gold standard

6

Management

Conservative commonly

Do not resolve within 24-48 hours:
- endoscopic decompression
- Neostigmine: anti-cholinesterase