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J Korean Med Sci.  2014 May;29(5):699-703. 10.3346/jkms.2014.29.5.699.

The Clinical Characteristics of Colonic Pseudo-obstruction and the Factors Associated with Medical Treatment Response: A Study Based on a Multicenter Database in Korea

Affiliations
  • 1Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea. kjleemd@hotmail.com
  • 2Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • 3Department of Gastroenterology, Gyeongsang National University School of Medicine, Jinju, Korea.
  • 4Department of Gastroenterology, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 5Department of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
  • 6Department of Gastroenterology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea.
  • 7Department of Gastroenterology, Dankook University College of Medicine, Cheonan, Korea.
  • 8Department of Gastroenterology, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 9Department of Gastroenterology, Soonchunhyang University Hospital, Seoul, Korea.
  • 10Department of Gastroenterology, Keimyung University School of Medicine, Daegu, Korea.
  • 11Department of Gastroenterology, Ewha Womans University School of Medicine, Seoul, Korea.
  • 12Department of Gastroenterology, Chung-Ang University College of Medicine, Seoul, Korea.
  • 13Department of Gastroenterology, Pusan National University School of Medicine, Busan, Korea.
  • 14Department of Gastroenterology, Dongguk University Ilsan Hospital, Goyang, Korea.
  • 15Department of Gastroenterology, Eulji University School of Medicine, Seoul, Korea.

Abstract

Colonic pseudo-obstruction (CPO) is defined as marked colonic distension in the absence of mechanical obstruction. We aimed to investigate the clinical characteristics of CPO and the factors associated with the response to medical treatment by using a multicenter database in Korea. CPO was diagnosed as colonic dilatation without mechanical obstruction by using radiologic and/or endoscopic examinations. Acute CPO occurring in the postoperative period in surgical patients or as a response to an acute illness was excluded. CPO cases were identified in 15 tertiary referral hospitals between 2000 and 2011. The patients' data were retrospectively reviewed and analyzed. In total, 104 patients (53 men; mean age at diagnosis, 47 yr) were identified. Seventy-seven of 104 patients (74%) showed a transition zone on abdominal computed tomography. Sixty of 104 patients (58%) showed poor responses to medical treatment and underwent surgery at the mean follow-up of 7.4 months (0.5-61 months). Younger age at the time of diagnosis, abdominal distension as a chief complaint, and greater cecal diameter were independently associated with the poor responses to medical treatment. These may be risk factors for a poor response to medical treatment.

Keyword

Colonic Pseudo-obstruction; Abdominal Distension; Colonic Dilatation; Transition Zone

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Child
Colon/*pathology/surgery
Colonic Pseudo-Obstruction/*diagnosis/*pathology/surgery
Constipation/diagnosis
Dilatation, Pathologic
Female
Humans
Male
Middle Aged
Republic of Korea
Retrospective Studies
Sagittal Abdominal Diameter
Tomography, X-Ray Computed
Treatment Outcome
Young Adult
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