انسداد القولون الكاذب الحاد عندما لا ينجح العلاج المحافظ

References

• ACPO, synonymous with Ogilvie’s syndrome, is characterized by an acute presentation of massive dilation of the large intestine in the absence of a mechanical etiology.
• In patients with uncomplicated ACPO (absence of ischemia, peritonitis, cecal diameter >12 cm, and/or significant abdominal pain), conservative management remains first-line therapy.
• For patients with ACPO who are not candidates for conservative therapy, have failed conservative therapy (up to 72 hours), or are at risk for perforation and have no contraindication to its use, we recommend pharmacologic therapy with neostigmine (2 mg over 3-5 minutes) with appropriate cardiovascular monitoring.
• Neostigmine, a short-acting anticholinesterase parasympathomimetic agent, remains the pharmacologic agent of choice in the management of ACPO.
• Coadministration of glycopyrrolate may be useful in preventing side effects of the medication, including hypersalivation and bronchospasm.

DOI: 10.1016/j.gie.2019.09.007