ACPO بدون نقص التروية أو الانثقاب — عندما لم يُجدِ النيوستيغمين عبر المسارات البديلة

References

DOI: 10.1016/j.gie.2019.09.007

• 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 or have failed conservative therapy (up to 72 hours) and have no contraindication to endoscopy, we suggest colonic decompression with decompression tube placement as an alternative.
• The procedure should be performed by an experienced endoscopist using water infusion and minimal to no insufflation of carbon dioxide rather than air.
• Sedation with benzodiazepines or other non-narcotic medication is preferred, because narcotics potentiate colonic atony.