Document Detail


Neostigmine to relieve a suspected colonic pseudo-obstruction in a burn patient: a case-based review of the literature.
MedLine Citation:
PMID:  23359843     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Objective: Neostigmine is one of the treatment options for colonic pseudo-obstruction in the medical patient. However, experience in using neostigmine for this indication in burn patients has not been reported in the literature. We will present a case of a woman who developed colonic pseudo-obstruction during her hospital stay. When conservative management failed, neostigmine was administered with no adverse effects and resolution of the pseudo-obstruction. We will review the literature regarding the pathophysiology and treatment options for acute colonic pseudo-obstruction in burn patients. Methods: A 27-year-old woman with 35% total body surface area deep-partial and full-thickness flame burns. On hospital day 17, she developed a nonobstructive ileus. She failed conservative medical therapy. After consultation with colleagues in trauma surgery and a review of the literature (MeSH/PubMed/NLM), the decision was made to try neostigmine therapy rather than a surgical/procedural option such as colonoscopy. Results: The patient was moved to the intensive care unit and 2 mg of neostigmine was administered intravenously over 4 minutes. After 30 minutes, all abdominal examination findings had returned to baseline. No significant adverse effects were noted, and she did not redevelop abdominal distension afterward. Conclusion: This case report provides an alternative treatment modality in which neostigmine was used successfully in a burn patient after conservative medical treatment had failed. The authors believe that neostigmine may be a viable alternative to decompressive colonoscopy in burn patients for whom mechanical obstruction is properly excluded.
Authors:
Abel A Gebre-Giorgis; Ensign Joseph D Roderique; Dane Stewart; Michael J Feldman; Andrea L Pozez
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Publication Detail:
Type:  Journal Article     Date:  2013-01-07
Journal Detail:
Title:  Eplasty     Volume:  13     ISSN:  1937-5719     ISO Abbreviation:  Eplasty     Publication Date:  2013  
Date Detail:
Created Date:  2013-01-29     Completed Date:  2013-01-30     Revised Date:  2013-04-08    
Medline Journal Info:
Nlm Unique ID:  101316107     Medline TA:  Eplasty     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1     Citation Subset:  -    
Affiliation:
The Evans-Haynes Burn Center, Virginia Commonwealth University Health Systems, Richmond.
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