Pseudo-obstruction

Superior mesenteric artery syndrome Enteric infections Inflammatory bowel diseases Pancreatitis Appendicitis Cholecystitis Biliary colic Gastroparesis Postvagotomy syndrome Intestinal pseudo-obstruction Functional dyspepsia Gastroesophageal reflux Peptic ulcer disease Hepatitis Peritonitis Gastric malignancy Liver failure... 

Functional bowel problems (e.g., Hirschsprung s disease, neuronal intestinal dysplasia, pseudo-obstruction, proteinlosing enteropathy, microvillous inclusion disease)... 

Di Lorenzo C, Flores AF, Buie T, Hyman PE Intestinal motility and jejunal feeding in children with chronic intestinal pseudo-obstruction. Gastroenterology 1995 108 1379-1385. 

Stanghellini V, Camilleri M, Malagelada JR Chronic idiopathic intestinal pseudo-obstruction Clinical and intestinal manometric findings. Gut 1987 28 5-12. 

Roy AD, Bharucha H, Nevin NC, Odling-Smee GW, Cockel R, Hill EE, et al Idiopathic intestinal pseudo-obstruction A familial visceral neuropathy. Clin Genet 1980 18 291-297. 

Khafagi FA, Lloyd HM, Gough IR Intestinal pseudo-obstruction in pheochromocytoma. AustNZ JMed 1987 17 246-248. 

Christensen J, Dent J, Malagelada JR, Wingate DL Pseudo-obstruction. Gastroenterology 1990 3/3 107—119. 

Gl obstruction (Concerts only) Because the Concerts tablet is nondeformable and does not appreciably change shape in the Gl tract, do not administer to patients with pre-existing severe Gl narrowing (eg, small bowel inflammatory disease, short gut syndrome because of adhesions or decreased transit time, history of peritonitis, cystic fibrosis, chronic intestinal pseudo-obstruction, Meckel s diverticulum). 

Octreotide inhibits intestinal secretion and has dose-related effects on bowel motility. In low doses (50 meg subcutaneously), it stimulates motility, whereas at higher doses (eg, 100-250 meg subcutaneously), it inhibits motility. Octreotide is effective in higher doses for the treatment of diarrhea due to vagotomy or dumping syndrome as well as for diarrhea caused by short bowel syndrome or AIDS. Octreotide has been used in low doses (50 meg subcutaneously) to stimulate small bowel motility in patients with small bowel bacterial overgrowth or intestinal pseudo-obstruction secondary to scleroderma. 

Cholinomimetics Neostigmine often used for colonic pseudo-obstruction in hospitalized patients... 

MNGIE [21] Intermittent diarrhea and intestinal pseudo-obstruction (myoneurogastrointestinal encephalopathy). Mutations in the thymidine-phosphorylase-encoding gene leads to multiple mtDNA deletion and anomalies in mtDNA synthesis. 

The term classical PNS is reserved for the PNS in which the association with cancer is common and includes encephalomyelitis, limbic encephalitis, paraneoplastic cerebellar degeneration, and paraneoplastic opsoclonus myoclonus (OM), as well as sensory neuronopathy (SN), chronic gastrointestinal pseudo-obstruction, Lambert Eaton myasthenic syndrome (LEMS), and dermatomyositis [14]. This chapter does not include dermatomyositis. 

Anti-CRMP5/CV2 CRMP5 Cytoplasm of oligodendrocytes Encephalomyelitis, cerebellar degeneration, LE, chorea, sensory neuronopathy, sensorimotor neuropathy, optic neuritis, gastrointestinal pseudo-obstruction SCLC, thymoma, gynecological tumors... 

Paraneoplastic autonomic neuropathy is primarily seen with SCLC [103]. Lymphoma, non-small cell lung cancer, and ovarian cancer are also associated with autonomic disturbances [104]. Autonomic dysfunction affects 23-30% of Hu antibody positive patients [36, 98] and is the predominant symptom at presentation in up to 9% of the patients [90]. The onset of symptoms is usually subacute. A prominent clinical manifestation in patients with paraneoplastic autonomic neuropathy is gastrointestinal dysmotility and intestinal pseudo-obstruction, which can occur as part of the PEM/SN syndrome or as the sole symptom of Hu antibody related PNS. Ortostatic hypotension and erectile dysfunction are other common features [37, 105, 106], Autonomic neuropathy is also commonly associated with the CRMP-5 antibody and have been detected in more than 30% of CRMP-5 antibody positive patients [30], Inflammation in autonomic ganglia and infiltration of B and T cells have been demonstrated at autopsy [107], and Hu antibodies have been shown to induce neuronal apoptosis in cultured myenteric neurons [105],... 

Viallard JF, Vincent A, Moreau JF, Parrens M, Pellegrin JL, Ellie E. Thymoma-associated neuromyotonia with antibodies against voltage-gated potassium channels presenting as chronic intestinal pseudo-obstruction. Eur Neurol 2005 53(2) 60-63. 

The possibility of fatal intestinal dilatation, although very rare, warrants careful evaluation of persistent complaints of constipation, particularly in patients who also have vomiting and abdominal pain, distension, or tenderness (518). Acute intestinal pseudo-obstruction (Ogilvie s syndrome) has been reported in a patient taking haloperidol plus benzatropine (519). 

Sheikh RA, Prindiville T, Yasmeen S. Haloperidol and benztropine interaction presenting as acute intestinal pseudo-obstruction. Am J Gastroenterol 2001 96(3) 934-5. 

Though usually innocuous, activated charcoal can in large or multiple doses, such as may be needed in severe poisoning, cause intestinal obstruction (3,6). Pseudo-obstruction can also occur if drugs that inhibit intestinal motility are given at the same time, and sometimes it is not clear which process has occurred (SED-12, 951) (SEDA-17, 426) (6). 

Aluminium hydroxide can cause constipation, or even intestinal obstruction. Severe bowel dysfunction developed in 25 of 945 patients receiving long-term hemodialysis during 10 years (47). There was colonic perforation in 12 patients, six of whom died with peritonitis. In 10 other patients there was prolonged, severe, adynamic ileus that progressed to colonic pseudo-obstruction in eight. All had regularly taken aluminium hydroxide gel and had had chronic constipation before presentation. 

When nifedipine is combined with intravenous magnesium to delay preterm labor, colonic pseudo-obstruction can occur (136). 

Pecha RE, Danilewitz MD. Acute pseudo-obstruction of the colon (Ogilvie s syndrome) resulting from combination tocolytic therapy. Am J Gastroenterol 1996 91(6) 1265-6. 

Constipation is frequent with clonidine, and one case of pseudo-obstruction of the bowel has been reported (19). 

Intestinal pseudo-obstruction has been attributed to fludarabine in a 66-year-old man with non-Hodgkin s lymphoma it was successfnUy managed with a combination of parasympathomimetic drngs and mechanical decompression (14). 

Campbell S, Thomas R, Parker A, Ghosh S. Fludarabine induced intestinal pseudo-obstruction case report and literature review. Eur J Gastroenterol Hepatol 2000 12(6) 711-13. 

Nausea, vomiting, and diarrhea in response to procainamide are common with dosages of 4 g/day or more (32). Pseudo-obstruction has been attributed to the use of a modified-release formulation of procainamide, perhaps due to its anticholinergic effects (33). 

Peterson AM, Conrad SD, Bell JM. Procainamide-induced pseudo-obstruction in a diabetic patient. DICP 1991 25(12) 1334-5. 

Pseudo-obstruction, a hypomotility or dysmotility disorder of the gastrointestinal tract that is thought to be a neuromuscular disorder of the smooth muscle and/or its innervation, often presents with the symptoms of bowel obstruction. Prolonged dysmotility can result in malnutrition as well as growth failure in children. Primary factors contributing to a risk of malnutrition are anorexia, nausea, vomiting, and obstruction, which may recur over years. Approximately 15% to 30% of patients with pseudo-obstruction require nutrition support with either PN or EN. ... 

Vargas JH, Sachs P, Ament ME. Chronic intestinal pseudo-obstruction syndrome in pediatrics Results of a national survey by members of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr 1988 7 323-332. 

Pseudo-obstruction PN is indicated in patients with prolonged dysmotility of the gastrointestinal tract distal to the pylorus, or in patients who cannot grow and gain weight with enteral nutrition alone. 

A woman taking methadone 140 mg daily for 6 years to manage pain due to chronic intestinal pseudo-obstruction was admitted to hospital because of a urinary tract infection and given ciprofloxacin 750 mg twice daily. Two days later she became sedated and confused. Ciprofloxacin was replaced with co-trimoxazole and the patient recovered within 48 hours. She was treated with ciprofloxacin for recurrent urinary-tract infections a further three times and on each occasion the patient bwame sedated, with her normal alertness regained on discontinuing ciprofloxacin. On the last oc-... 

In 1990, the CSM in the UK noted that, of 26 reports they had on record of hypokalaemia with unnamed xanthines or beta2 agonists, 9 occurred in patients receiving both groups of drugs. In 5 of these 9 cases, the hypokalaemia had no clinical consequence. However, in 2 cases it resulted in cardiorespiratory arrest, in another case confusion, and in a further case intestinal pseudo-obstruction. ... 

Constipation 203 Functional Constipation 203 Neurogenic Constipation 204 Hirschsprung s Disease 204 Chronic Intestinal Pseudo-obstruction 204 Imaging in Constipation 205 Imaging Findings in Hirschsprung s Disease 205... 

Imaging Findings in NID, Hypoganglionosis, Chronic Intestinal Pseudo-obstruction,... 

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