Our Summary
This research paper discusses a case of an 83-year-old man who experienced a serious bowel problem known as Acute Colonic Pseudo-obstruction (ACPO) after undergoing laparoscopic surgery for another bowel issue, sigmoid volvulus. ACPO is a condition where the colon (large intestine) becomes very enlarged, not because of a physical blockage, but due to the disruption of muscle contractions that move food through the digestive system.
The paper details the man’s experience after the surgery and the difficulties faced in diagnosing and treating his condition. Even though various medical treatments were tried, the man’s condition worsened and required additional surgery. The case emphasizes the need for quick diagnosis and aggressive treatment in cases of ACPO to avoid severe, possibly life-threatening complications and to improve the chance of a positive outcome for the patient.
FAQs
- What is Acute Colonic Pseudo-obstruction (ACPO)?
- How does a sigmoid volvulus lead to ACPO?
- What are the potential life-threatening consequences if ACPO is not diagnosed and managed early?
Doctor’s Tip
A doctor might tell a patient undergoing sigmoidectomy that it is important to follow postoperative care instructions carefully to prevent complications such as acute colonic pseudo-obstruction. This can include staying hydrated, eating a healthy diet, taking prescribed medications, and avoiding strenuous activity. It is also important to communicate any concerning symptoms to your healthcare provider promptly.
Suitable For
Patients who are typically recommended sigmoidectomy include those with conditions such as sigmoid volvulus, chronic diverticular disease, colorectal cancer, inflammatory bowel disease, or recurrent episodes of diverticulitis. Additionally, patients who have experienced complications such as perforation, obstruction, or severe bleeding in the sigmoid colon may also be candidates for sigmoidectomy. In cases of acute colonic pseudo-obstruction (ACPO) where conservative management has failed, surgical intervention such as sigmoidectomy may be necessary to relieve the colonic distension and prevent further complications.
Timeline
Before sigmoidectomy:
- Patient experiences symptoms of sigmoid volvulus such as abdominal pain, bloating, constipation, and vomiting.
- Diagnostic tests such as imaging studies and colonoscopy are performed to confirm the diagnosis.
- Patient undergoes laparoscopic surgery for sigmoid volvulus, specifically a sigmoidectomy to remove the affected portion of the colon.
After sigmoidectomy:
- Patient develops acute colonic pseudo-obstruction (ACPO) due to postoperative ileus or suture failure.
- Medical interventions such as bowel rest, nasogastric decompression, and pharmacological therapy are attempted to manage the condition.
- Despite conservative measures, patient’s condition worsens, necessitating further surgical intervention.
- Patient undergoes a second surgery to address complications related to ACPO.
- Early diagnosis and aggressive management are crucial in preventing life-threatening consequences and improving patient outcomes.
What to Ask Your Doctor
- What is the reason for recommending a sigmoidectomy?
- What are the potential risks and complications associated with the surgery?
- How long is the recovery process expected to be?
- What lifestyle changes or dietary restrictions will be necessary after the surgery?
- Will additional treatments or therapies be required after the sigmoidectomy?
- What is the success rate of sigmoidectomy for treating sigmoid volvulus?
- Are there any alternative treatment options available?
- How will the surgery impact my quality of life in the long term?
- What symptoms should I watch for that may indicate a complication after the surgery?
- How often will follow-up appointments be needed after the sigmoidectomy?
Reference
Authors: Nakamura K, Sakuraba S, Koido K, Hazama H, Ohata K. Journal: Cureus. 2024 May 26;16(5):e61133. doi: 10.7759/cureus.61133. eCollection 2024 May. PMID: 38800775