Systematic Reviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 14, 2017; 23(30): 5634-5644
Published online Aug 14, 2017. doi: 10.3748/wjg.v23.i30.5634
Acute colonic pseudo-obstruction: A systematic review of aetiology and mechanisms
Cameron I Wells, Gregory O’Grady, Ian P Bissett
Cameron I Wells, Gregory O’Grady, Ian P Bissett, Department of Surgery, University of Auckland, Auckland 1010, New Zealand
Gregory O’Grady, Ian P Bissett, Department of Surgery, Auckland District Health Board, Auckland 1010, New Zealand
Author contributions: All authors contributed to conception and design of the study; Wells CI acquired and analysed data; all authors contributed to interpretation of data, drafting and revising of the manuscript; all authors have given final approval of the version of the article to be published.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Ian P Bissett, Professor, Department of Surgery, University of Auckland, Private Bag 92019, Auckland Mail Centre 1142, Auckland 1010, New Zealand. i.bissett@auckland.ac.nz
Telephone: +64-9-3737599-89821 Fax: +64-9-3779656
Received: May 26, 2017
Peer-review started: May 28, 2017
First decision: June 23, 2017
Revised: June 29, 2017
Accepted: July 22, 2017
Article in press: July 24, 2017
Published online: August 14, 2017
Processing time: 80 Days and 1 Hours
Abstract
AIM

To critically review the literature addressing the definition, epidemiology, aetiology and pathophysiology of acute colonic pseudo-obstruction (ACPO).

METHODS

A systematic search was performed to identify articles investigating the aetiology and pathophysiology of ACPO. A narrative synthesis of the evidence was undertaken.

RESULTS

No consistent approach to the definition or reporting of ACPO has been developed, which has led to overlapping investigation with other conditions. A vast array of risk factors has been identified, supporting a multifactorial aetiology. The pathophysiological mechanisms remain unclear, but are likely related to altered autonomic regulation of colonic motility, in the setting of other predisposing factors.

CONCLUSION

Future research should aim to establish a clear and consistent definition of ACPO, and elucidate the pathophysiological mechanisms leading to altered colonic function. An improved understanding of the aetiology of ACPO may facilitate the development of targeted strategies for its prevention and treatment.

Keywords: Acute colonic pseudoobstruction; Acute colonic pseudo-obstruction; Colonic; Intestinal; Pseudo obstruction; Ogilvie’s syndrome; Pseudo-Obstruction; Pseudo-Obstruction

Core tip: Acute colonic pseudo-obstruction is associated with considerable morbidity and mortality, though the underlying pathophysiology remains poorly understood. An abundance of risk factors and associated conditions have been identified, strongly suggesting a multifactorial origin, and likely culminating in an imbalance in autonomic nervous supply to the colon. Future areas for research are identified and may allow for the development of novel therapeutic or preventative strategies.