Clin Colon Rectal Surg 2021; 34(04): 242-250
DOI: 10.1055/s-0041-1727195
Review Article

Acute Colonic Pseudo-obstruction and Volvulus: Pathophysiology, Evaluation, and Treatment

Joshua Underhill
1  Department of General Surgery, Rush University Medical Center, Chicago, Illinois
,
Emily Munding
1  Department of General Surgery, Rush University Medical Center, Chicago, Illinois
,
Dana Hayden
1  Department of General Surgery, Rush University Medical Center, Chicago, Illinois
› Author Affiliations

Abstract

Acute colonic pseudo-obstruction (ACPO) and volvulus are two disease processes that affect the colon causing abdominal distension and may necessitate operation intervention. ACPO may be associated with multiple comorbidities, infectious diseases, and cardiac dysfunction. It may be treated with conservative management including endoscopic decompression or neostigmine. If the distension is not addressed, high mortality may result if peritonitis develops. Volvulus most commonly occurs in the sigmoid colon or cecum. If left-sided, endoscopic decompression may resolve the obstruction if detorsion is successful, although sigmoid colectomy should be performed during the admission. If cecal volvulus is identified, right hemicolectomy should be performed.



Publication History

Publication Date:
20 July 2021 (online)

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