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ddx
hirschprung, toxic megacolon, vovulus, fecal impaction, distal obstructing lesion
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sx, dx
- abdominal distention
- pain
- constipation, occ diarrhea
- basically a radiological dx
-
rx-medical
- NPO, NGT, correct fluid and electrolyte abnormalities
- treat infection
- gentle enemas
- rectal tube
- decrease narcotics
-
rx- colonoscopy
- most effective
- tap water enema 1000cc
- catheter over guide wire
- post xray
-
rx medical
- cause is excess sympathetic tone>
- epidural, splanchnic sympathetic blockade
cause is excessive parasympathetic suppression>IV neostigmine
-
RX SX for impending cecal perf
- open cecostomy
- CT guided perc cecostomy
- perc colonoscopic ceocostomy
- laparoscoic guided perc cecostomy with T fasteners
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