TY - JOUR
T1 - Refractory Acute Colonic Pseudo-Obstruction Complicated by Urosepsis and Parkinsonism
AU - Hu, Chao-Kai
AU - Liu, Chih-Chung
AU - Hung, Ming-Hui
AU - Chan, Wing-Sum
AU - Yeh, Yu-Chang
PY - 2008
Y1 - 2008
N2 - Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome, consists of massive colonic dilatation in the absence of distal colonic mechanical obstruction. It develops in hospitalized patients and is associated with a variety of surgical and medical conditions, such as autonomic dysregulation of colonic motor activity, after major surgery, electrolyte imbalance, or systemic infection. Conservative management or pharmacological therapy with neostigmine is usually sufficient to control ACPO, but colonoscopy for intestinal decompression is sometimes needed. We report a patient with Parkinson's disease who developed ACPO after septic shock. Low dose of neostigmine (1 mg) is effective for short-term symptom relief; but the symptoms might be recurrent and refractory if the underlying risk factors are not improved. Without appropriate management, ACPO will prolong the duration of mechanical ventilation and ICU stay of those critical patients.
AB - Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome, consists of massive colonic dilatation in the absence of distal colonic mechanical obstruction. It develops in hospitalized patients and is associated with a variety of surgical and medical conditions, such as autonomic dysregulation of colonic motor activity, after major surgery, electrolyte imbalance, or systemic infection. Conservative management or pharmacological therapy with neostigmine is usually sufficient to control ACPO, but colonoscopy for intestinal decompression is sometimes needed. We report a patient with Parkinson's disease who developed ACPO after septic shock. Low dose of neostigmine (1 mg) is effective for short-term symptom relief; but the symptoms might be recurrent and refractory if the underlying risk factors are not improved. Without appropriate management, ACPO will prolong the duration of mechanical ventilation and ICU stay of those critical patients.
KW - 急性大腸假性阻塞
KW - 奧格維氏症候群Ogilvie's syndrome
KW - 新斯狄格明neostigmine
KW - Acute colonic pseudo-obstruction
KW - Ogilvie's syndrome
KW - Neostigmine
U2 - 10.30035/TCCM.200803.0006
DO - 10.30035/TCCM.200803.0006
M3 - Article
SN - 1563-356x
VL - 9
SP - 42
EP - 46
JO - 重症醫學雜誌
JF - 重症醫學雜誌
IS - 1
ER -