Acute Colonic Pseudo-Obstruction (ACPO)

Acute Colonic Pseudo-Obstruction (ACPO), also commonly referred to as Ogilvie’s syndrome, is a non-mechanical induced significant dilatation of the colon. The enteric nervous system innervates the colon and regulates absorption, secretion, and local blood flow in response to colonic content. The enteric nervous system is connected to the brainstem and spine via the sympathetic and parasympathetic autonomic nerve system which respectively inhibit colon motility and function and promotes the digestive and motility function of the colon. ACPO is a severe functional impairment of transit for colonic content due to presumed autonomic dysfunction. The colon can accordingly dilate enough to cause colonic wall death, perforation, and risk of mortality. Management of ACPO requires recognition and careful assessment to rule out mechanical obstruction, and timely medical, endoscopic and/or surgical decompression.