Pseudo-obstruction Flashcards
1
Q
Pseudo-obstruction
A
Acute dilatation of the colon in the absence of a mechanical obstruction
- interruption of the ANS in colon
- absence of smooth muscle action
2
Q
Causes
A
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
Q
Complications
A
Toxic megacolon
Bowel ischaemia
Perforation
4
Q
Clinical features
A
Abdominal pain
Abdominal distension
Constipation
Vomiting - late feature
Often soft and non - tender abdomen
5
Q
Investigations
A
Bloods including
- Ca2+
- Mg 2+
- TFTs
AXR - bowel distention
abdominal-pelvis CT scan with IV contrast - Gold standard
6
Q
Management
A
Conservative commonly
Do not resolve within 24-48 hours:
- endoscopic decompression
- Neostigmine: anti-cholinesterase
