Colonic decompression in daily practice

Czech version

Authors: I. Mikoviny Kajzrlíková ¹; P. Vítek ^1,2; J. Chalupa ¹; J. Kuchař ¹; J. Platoš ¹; P. Řeha ¹; M. Chrostek ³
Authors‘ workplace: Beskydské Gastrocentrum, Interní oddělení, Nemocnice ve Frýdku-Místku, p. o. ¹; Lékařská fakulta OU, Ostrava ²; Beskydské Gastrocentrum, Chirurgické oddělení, Nemocnice ve Frýdku-Místku, p. o. ³
Published in: Gastroent Hepatol 2017; 71(3): 215-219
Category: Digestive Endoscopy: Original Article
doi: https://doi.org/10.14735/amgh2017215

Overview

Introduction:
Endoscopic management of some types of intestinal obstruction or pseudo-obstruction is an unusual indication for acute colonoscopy. The aim of this study was to assess the frequency of, indications for, and results of colonic decompression.

Methods:
All colonoscopies for intestinal obstruction or pseudo-obstruction with insertion of a decompression tube and endoscopic reduction of the sigmoid volvulus carried out from August, 2011, to December, 2016 at our institution, were retrospectively assessed. For each patient, age, sex, comorbidities, etiology of ileus and indication for decompression, part of the colon reached during acute colonoscopy, effect of decompression, and follow-up were recorded.

Results:
During the study period, 23 colonic decompressions were performed in 21 patients (11 men and 10 women) with an average age of 68 years (median, 73 years). The indication for decompression was Ogilvie’s syndrome in 14 patients, sigmoid volvulus in two patients, pseudomembranous colitis with toxic megacolon in one patient, paralytic ileus caused by ischemic colitis in one patient with multiple organ dysfunction syndrome, ileus due to benign anastomotic stricture in the rectum in one patient, and mechanical ileus that was initially considered to be Ogilvie’s syndrome in two patients. Because most of the patients were elderly with comorbidities, the 30-day mortality rate was 28.6%.

Conclusions:
The most frequent indication for colonic decompression was Ogilvie’s syndrome. The 30-day mortality rate was high because most of the patients were elderly with comorbidities. Sigmoid volvulus can be successfully managed endoscopically, and decompression is more effective with the insertion of a decompression tube.

Key words:
decompression – colonoscopy – colonic pseudo-obstruction – intestinal volvulus – mortality

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
18. 4. 2017

Accepted:
11. 5. 2017

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