Dataset Information

Acute Colonic Pseudo-Obstruction with Feeding Intolerance in Critically Ill Patients: A Study according to Gut Wall Analysis.

ABSTRACT: Objective. To compare the differences between acute colonic pseudo-obstruction (ACPO) with and without acute gut wall thickening. Methods. ACPO patients with feeding tolerance were divided into ACPO with no obvious gut wall thickening (ACPO-NT) group and ACPO with obvious acute gut wall thickening (ACPO-T) group according to computed tomography and abdominal radiographs. Patients' condition, responses to supportive measures, pharmacologic therapy, endoscopic decompression, and surgeries and outcomes were compared. Results. Patients in ACPO-T group had a significantly higher APACHE II (11.82 versus 8.25, p = 0.008) and SOFA scores (6.47 versus 3.54, p < 0.001) and a significantly higher 28-day mortality (17.78% versus 4.16%, p = 0.032) and longer intensive care unit stage (4 versus 16?d, p < 0.001). Patients in ACPO-NT group were more likely to be responsive to supportive treatment (62.50% versus 24.44%, p < 0.001), neostigmine (77.78% versus 17.64%, p < 0.001), and colonoscopic decompression (75% versus 42.86%, p = 0.318) than those in ACPO-T group. Of the patients who underwent ileostomy, 81.25% gained benefits. Conclusions. ACPO patients with gut wall thickening are more severe and are less likely to be responsive to nonsurgical treatment. Ileostomy may be a good option for ACPO patients with gut wall thickening who are irresponsive to nonsurgical treatment.

SUBMITTER: Zhao C

PROVIDER: S-EPMC5366232 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Acute Colonic Pseudo-Obstruction with Feeding Intolerance in Critically Ill Patients: A Study according to Gut Wall Analysis.

Zhao Chenyan C Xie Tingbin T Li Jun J Cheng Minhua M Shi Jialiang J Gao Tao T Xi Fengchan F Shen Juanhong J Cao Chun C Yu Wenkui W

Gastroenterology research and practice 20170312

<i>Objective</i>. To compare the differences between acute colonic pseudo-obstruction (ACPO) with and without acute gut wall thickening. <i>Methods</i>. ACPO patients with feeding tolerance were divided into ACPO with no obvious gut wall thickening (ACPO-NT) group and ACPO with obvious acute gut wall thickening (ACPO-T) group according to computed tomography and abdominal radiographs. Patients' condition, responses to supportive measures, pharmacologic therapy, endoscopic decompression, and surg ...[more]

PMID: 28386273

Similar Datasets

Project description:ObjectivesPneumatosis intestinalis is a rare condition with subserosal or submucosal gas-filled cysts of the gastrointestinal tract. It is often associated with acute mesenteric ischemia, but also non-ischemic causes are described.Case presentationA 27-year-old male patient with severe congenital spastic tetraparesis presented to the emergency room with fever and reduced general condition. The patient was hypotonic and tachycardic, had a fever up to 39.7 °C and reduced peripheral oxygen saturation. The laboratory analyses revealed leukocytosis (16.7 G/L) and elevated CRP (162 mg/L).The patient was admitted to the intensive care unit (ICU) for invasive ventilator treatment because of global respiratory insufficiency and antibiotic therapy due to acute pneumonia and severe acute respiratory distress syndrome (ARDS). In addition, he suffered from colonic pseudo-obstruction but with persistent stool passage. After pulmonary recovery, he was transferred to the normal ward of internal medicine, but signs of colonic pseudo-obstruction were still present.Under therapy with diatrizoic acid and neostigmine, the abdomen was less distended, and the patient had regular bowel movements. After four days, the patient developed sudden acute abdominal pain and suffered sudden pulseless electrical activity. Immediate cardiopulmonary resuscitation was provided. After the return of spontaneous circulation, the patient underwent computed tomography (CT) and was re-admitted to the ICU. The CT scan showed massive dilatation of the colon, including pneumatosis coli, extensive gas formation within the mesenteric veins and arteries, including massive portal gas in the liver, the splenic vein, the renal veins, and disruption of abdominal aortic perfusion. The patient was then first presented for surgical evaluation, but due to futile prognosis, treatment was ceased on the ICU.ConclusionsIn conclusion, colonic pseudo-obstruction might have led to colonic necrosis and consecutive massive gas formation within the mesenteric vessels. Therefore, intestinal passage should be restored as soon as possible to avoid possible mortality.

Dataset Information

Acute Colonic Pseudo-Obstruction with Feeding Intolerance in Critically Ill Patients: A Study according to Gut Wall Analysis.

Publications

Acute Colonic Pseudo-Obstruction with Feeding Intolerance in Critically Ill Patients: A Study according to Gut Wall Analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets