ABSTRACT
The most common clinical presentation of acute colonic pseudo-obstruction (ACPO) is similar to acute large bowel obstruction, which progressively develops over the course of a few days usually in an elderly patient with multiple co-morbidities, often bedridden or with limited mobility that may have had a orthopaedic surgical procedure. The colon in ACPO can become significantly dilated, which increases the risk of colonic perforation leading to faeculent peritonitis and potentially death from septicaemia. The differential diagnosis of ACPO other than malignant large bowel obstruction includes benign causes of colonic stricture, such as diverticulitis, inflammatory bowel disease, radiation colitis, volvulus, intussusception, foreign body, bezoar, faecaloma, anastomotic stricture and extrinsic compression. The management principles of ACPO revolve on an initial trial of supportive management without active intervention. A pharmacological approach has been conceived, with the aim of shortening the natural history of ACPO.
