Etiology and prognosis of acute colonic pseudo-obstruction: a retrospective study in an internal medicine unit.

Purpose. - To analyze the context in which acute colonic pseudo-obstruction s occur in a medical practice. Method. - Retrospective study of patients with an acute colonic pseudo-obst ruction hospitalized in an internal medicine department between November 19 92 and December 1999. Results. - We found 12 patients including eight men (mean age: 80.2 years). All had abdominal pains. Seven patients presented an occlusive syndrome. A septic shock occurred in two subjects. The average diameter of the cecum w as 10 cm. Distention involved the whole colon for nine patients, and only t he left part for three. Six subjects were affected by a bronchopneumonia, t hree had a previous history of recent diarrhea, two had colonic diverticuli tis, and two others had a diabetic neuropathy. Ogilvie's syndrome revealed hypothyroidism for one patient. Nine patients were taking one or more medic ations incriminated in the acute colonic pseudo-obstruction: calcium-channe l blockers (n = 6), neuroleptics (n = 5), antidepressant agents (n = 4), do paminergic drugs (n = 2) and opiates (n = 1). Five patients underwent a col onoscopic decompression. Surgical procedures were undertaken for three pati ents: one underwent a complete colectomy because of numerous perforation. E xcept for the colectomized patient, the outcome resulted in either recovery (n = 7), partial improvement (n = 3), or recurrence (n = 1). Conclusion. - in a medical environment, acute colonic pseudo-obstruction is a pathology for elderly persons, namely with a masculine predominance and often associated with iatrogenic factors. The outcome is more often than no t favorable, but it may result in invasive acts or significant complication s at this age. (C) 2001 Editions scientifiques et medicales Elsevier SAS.