Gastrointestinal pseudo-obstruction: Report of a patient with postoperative pseudo-obstruction

Postoperative pseudo-obstruction is a rare state of protracted gastrointest inal paresis that may progress to paralysis without the presence of obstruc tive lesions. Pseudo -obstruction is usually, but not exclusively, associat ed with an abdominal operative procedure (laparotomy), however it may occas ionally occur following extra-abdominal operations. As differentiated from the usual, 'physiologic' postoperative paresis, pseudo-obstruction persists for more than 7 days. The pathogenesis of postoperative pseudo-obstruction is complex and as yet partially unknown. Whereas the 'physiologic' postope rative gastrointestinal paresis includes short-term functional cholinergic depression of the visceral organs, in pseudo-obstruction focal lesions in. the region of Auerbach's plexus, manifesting as visceral neuromyopathy, are involved. That is why the 'physiologic' postoperative paresis never transf orms into paralytic ileus, while in pseudo-obstruction such a risk is poten tially involved. The treatment for pseudo-obstruction is as a rule conserva tive. Surgical treatment (cecostomy) is rarely required. Colonoscopic decom presive suction, is usually enough to eliminate the risk of colon rupture d ue to extensive distention by fast growing meteorism. A patient with postop erative pseudo-obstruction is presented.