7 May 2019
Case ReportAcute colonic pseudo-obstruction in elderly. Report of a case
Vincenzo Formisano 1Gianpiero Cione 1Antonio Muria 1Filippo Carlo 1Antonella Capasso 2Serena Russo 2Luigi Angrisani 1
Affiliations
Article Info
1 General Laparoscopic and Emergency Surgery, “S. Giovanni Bosco” Hospital, Naples, Italy
2 Pathological Anatomy and Histopathology Unit, S.M.P.d.I. Hospital, Naples, Italy
Ann. Ital. Chir., 2019, 8(May), 152180;
Published: 7 May 2019
Copyright (c) 2019 Annali Italiani di Chirurgia
Abstract
A case of acute colonic obstruction in an elderly patient is presented, with a brief discussion about peculiar aspects to pseudo-obstruction and particularly chronic idiopathic intestinal pseudo-obstruction (CIIP), in which it was classified by pathologists. Clinical and therapeutic implications of this classification are also discussed. In authors’opinion, interesting aspects of the reported case are represented by the acute presentation, without previous symptoms at medical history and above all by the evidence of a recto-sigmoid junction intraoperatively palpable mass, mimicking ring-like neoplastic disease. The preoperative and intraoperative features led surgeons to perform a total colectomy with ileo-rectal anastomosis and high ligation of mesenteric inferior artery, with complete regional lymphectomy according to oncologic standard, but at histological examination the mass revealed to be due to considerable muscular tissue thickening, therefore to a benign condition. These features probably suggest the need of a better clinical and pathological classification of this difficult and still controversial matter, in order to achieve better outcomes and to avoid misdiagnosis and overtreatment.
Keywords
- Intestinal obstruction
- Pseudo-obstruction
- Total colectomy
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