NEUROMUSCULAR STATES OF THE LARGE INTESTINE WITH D

NEUROMUSCULAR STATES OF THE LARGE INTESTINE WITH DILATATION: ACUTE COLONIC PSEUDO-OBSTRUCTION Definition

The term acute colonic pseudo-obstruction (ACPO) is defined /uni00A0 as: Acute massive dilatation of the colon with obstructive symptoms but in the absence of mechanical obstruction. ACPO was first described by Sir William Ogilvie, who in 1948 recognised this syndrome in two patients with sudden onset of abdominal pain, constipation and large bowel dilatation (hence the eponym Ogilvie’s syndr ome). It is one of the three common diagnoses in patients evaluated for a clinical presentation of large bowel obstruction (see Chapter 78 other two being colorectal cancer and volvulus (remember the three Ts: tumour, torsion and ‘tired out’). Toxic megacolon (see Chapter 75 ), although conveniently being a fourth ‘T’, should be considered as a di ff erent condition entirely although the end point is also one of acute dilatation.