| Neostigmine to relieve a suspected colonic pseudo-obstruction in a burn patient: a case-based review of the literature. | |
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MedLine Citation:
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PMID: 23359843 Owner: NLM Status: PubMed-not-MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Abel A Gebre-Giorgis; Ensign Joseph D Roderique; Dane Stewart; Michael J Feldman; Andrea L Pozez |
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Publication Detail:
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Type: Journal Article Date: 2013-01-07 |
Journal Detail:
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Title: Eplasty Volume: 13 ISSN: 1937-5719 ISO Abbreviation: Eplasty Publication Date: 2013 |
Date Detail:
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Created Date: 2013-01-29 Completed Date: 2013-01-30 Revised Date: 2013-04-08 |
Medline Journal Info:
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Nlm Unique ID: 101316107 Medline TA: Eplasty Country: United States |
Other Details:
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Languages: eng Pagination: e1 Citation Subset: - |
Affiliation:
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The Evans-Haynes Burn Center, Virginia Commonwealth University Health Systems, Richmond. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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