Colonic pseudo-obstruction

Case contributed by Dr Chris O'Donnell

Presentation

Gross painless abdominal distension in an elderly patient.

Patient Data

Age: 85 years
Gender: Male
CT

Gross colonic dilatation from cecum to anus with no obstructing lesion identified - typical of this syndrome.

Case Discussion

CT is helpful in delineating the cause of bowel dilatation.  Always look for a point of transition from dilated to collapsed bowel = site of obstruction.  In this case there is no transition point to the anus this mechanical obstruction is unlikely.  On that basis this is likely to be a functional disorder of the bowel ie poor or absent peristalsis.  Dilatation can be extreme even leading to venous ischemia of the bowel wall and perforation.

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Case information

rID: 20709
Published: 8th Dec 2012
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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