BACKGROUND: Acute @entity4391 -- that is, massive dilation of the colon without mechanical obstruction -- may develop after surgery or severe @entity221 . Although it may resolve with conservative therapy, colonoscopic decompression is sometimes needed to prevent @entity63 and perforation of the bowel. Uncontrolled studies have suggested that @entity1339 , may be an effective treatment. METHODS: We studied 21 @entity1 with acute @entity4391 . All had @entity1661 and radiographic evidence of @entity384 , with a cecal diameter of at least 10 cm, and had had no response to at least 24 hours of conservative treatment. We randomly assigned 11 to receive 2.0 mg of @entity1339 intravenously and 10 to receive intravenous saline. A physician who was unaware of the @entity1 ' treatment assignments recorded clinical response (defined as prompt evacuation of flatus or stool and a @entity1625 ), abdominal circumference, and measurements of the colon on radiographs. @entity1 who had no response to the initial injection were eligible to receive open-label @entity1339 three hours later. RESULTS: Ten of the 11 @entity1 who received @entity1339 had prompt colonic decompression, as compared with none of the 10 @entity1 who received placebo (P<0.001). The median time to response was 4 minutes (range, 3 to 30). Seven @entity1 in the placebo group and the one @entity1 in the @entity1339 group without an initial response received open-label @entity1339 ; all had colonic decompression. Two @entity1 who had an initial response to @entity1339 required colonoscopic decompression for recurrence of @entity694 ; one eventually underwent subtotal colectomy. Side effects of @entity1339 included @entity490 , excess @entity391 . Symptomatic @entity1168 developed in two @entity1 and was treated with @entity3897 . CONCLUSIONS: In @entity1 with acute @entity4391 who have not had a response to conservative therapy, treatment with @entity1339 rapidly decompresses the colon.

@entity1339 for the treatment of acute XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity1625 :: ('MESH:D004828', 'Disease') :: ['reduction in abdominal distention'] @entity4391 :: ('MESH:D003112', 'Disease') :: ['colonic pseudo-obstruction'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia'] @entity384 :: ('MESH:D002311', 'Disease') :: ['colonic dilation'] @entity1168 :: ('MESH:D001919', 'Disease') :: ['bradycardia'] @entity1661 :: ('MESH:D000008', 'Disease') :: ['abdominal distention'] @entity391 :: ('MESH:D014839', 'Disease') :: ['salivation, and vomiting'] @entity490 :: ('MESH:D015746', 'Disease') :: ['abdominal pain'] @entity3897 :: ('MESH:D001285', 'Chemical') :: ['atropine'] @entity694 :: ('MESH:D003110', 'Disease') :: ['colonic distention'] @entity221 :: ('MESH:D005334', 'Disease') :: ['illness'] @entity1339 :: ('MESH:D009388', 'Chemical') :: ['neostigmine']
@entity4391 :: (MESH:D003112,Disease) :: ['colonic pseudo-obstruction']
