Pseudo-obstruction of the colon is a problem of bowel motility that
predominantly involves the large intestine and that can mimic the clinical
and radiographic features of mechanical obstruction of the colon. It must
not be confused with the much more common and less dangerous complication
of post-operative ileus. Although it is most often seen in elderly patients
who are confined to bed, it can occur in younger patients. Cecal dilation
can develop rapidly to dangerous proportions, and recognition by thorough
physical examination and early abdominal radiographs is essential if
operative intervention is to be avoided. Nasogastric suction, intravenous
fluids, and frequent turning of the patient are often successful if begun
early, but are unlikely to be of benefit once cecal dilation approaches
fourteen centimeters on plain radiographs. In these advanced cases, tube
cecostomy or colostomy may be the only way to avoid necrosis of the bowel
wall, perforation, and sepsis.