FluoroscopyĪ single contrast/water-soluble enema demonstrates the absence of any mechanical obstruction. Pseudo-obstruction is related to decreased parasympathetic activity.įindings can be identical to a mechanical large bowel obstruction 1. Bowel sounds are normal or high-pitched, but should not be absent.ĭespite the absence of mechanical obstruction, patients can nonetheless go on to bowel necrosis and perforation (especially if dilatation is severe) which in turn can go on to become generalized peritonitis 3. Pseudo-obstruction can present with a sudden painless enlargement of the proximal colon accompanied by distension. Patients usually present with constipation, nausea, vomiting and abdominal distension. Usually seen in people over 60 years of age and there is male predilection 5.
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