급성 대장 가성 폐쇄증에서 Neostigmine의 치험 1예
A Case of Neostigmine Trial in Acute Colonic Pseudo-obstruction
김완수, 한상영, 배이지, 장진석, 장진석, 이종훈, 노명환, 최석렬, 신우원,
소속 상세정보
김완수 ( Kim Wan-Su )
동아대학교 의과대학 내과학교실
한상영 ( Han Sang-Young )
동아대학교 의과대학 내과학교실
배이지 ( Bae Yee-Zee )
동아대학교 의과대학 내과학교실
장진석 ( Jang Jin-Seok )
동아대학교 의과대학 내과학교실
장진석 ( Jang Jin-Seok )
동아대학교 의과대학 내과학교실
이종훈 ( Lee Jong-Hoon )
동아대학교 의과대학 내과학교실
노명환 ( Roh Myung-Hwan )
동아대학교 의과대학 내과학교실
최석렬 ( Choi Seok-Reyol )
동아대학교 의과대학 내과학교실
신우원 ( Shin Woo-Won )
동아대학교 의과대학 내과학교실
KMID : 0614620030410010064
Abstract
Acute colonic pseudo-obstruction (ACPO) known as Ogilvie`s syndrome is characterized by massive dilatation of the colon without a mechanical obstruction with unclear pathophysiology. The ACPO is associated with wide variety of medical and surgical conditions, especially pregnancy, cesarean section, and trauma. Usually, the conservative therapy of 2-3 days is enough for its treatment. However, if it shows no effect, colonoscopic decompression is recommended. As an alternative, neostigmine has been reported to be effective in the treatment of ACPO. Here, we report a case of idiopathic ACPO treated with neostigmine. The initial treatment was conservative but showed no effect, and thus colonoscopic decompression was followed. After decompression, symptoms improved. However, 10 days after decompression, abdominal distension recurred. Thus, we injected 2.0 mg of neostigmine intravenously for 3 minutes. It improved the symptom. Seven days later, the symptoms were aggravated, so 1.0 mg of neostigmine was administrated twice, which did not work. The patient was transferred for exploration, and a total colectomy was carried out. Seven days after colectomy, the patient died of sepsis. (Korean J Gastroenterol 2003;41:64-69)
키워드
Colonic pseudo-obstruction; Neostigmine;
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