Colostomy as a definitive treatment in an ALS patient with acute colonic Pseudo-obstruction refractory to medical management, a case report

Guanghao Liu; Jennifer Hrabe; Rolando Sanchez

doi:10.1186/s12883-022-02893-x

$Colostomy as a definitive treatment in an ALS patient with acute colonic Pseudo-obstruction refractory to medical management, a case report$

Journal article

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Peer reviewed

Colostomy as a definitive treatment in an ALS patient with acute colonic Pseudo-obstruction refractory to medical management, a case report

Guanghao Liu, Jennifer Hrabe and Rolando Sanchez

BMC neurology, Vol.22(1), 366

09/22/2022

DOI: 10.1186/s12883-022-02893-x

PMCID: PMC9494822

PMID: 36138349

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Abstract

Background Amyotrophic lateral sclerosis (ALS) is a fatal motor neuron disease, and ALS patients may experience disturbed gastrointestinal motility often resulting in acute colonic pseudo-obstruction (ACPO). There is currently a paucity in the literature to guide the treatment of patients with both ALS and ACPO. Case presentation Here we describe a 39-year-old male patient with advanced ALS who developed ACPO. His condition was refractory to both medical and procedural managements including polyethylene glycol, senna, and docusate suppository, metoclopramide, linaclotide, erythromycin, prucalopride, neostigmine, and repeated colonoscopies. He ultimately underwent successful colostomy for palliation. Here we report the peri-operative multidisciplinary approach taken with this case, the surgical procedures, the potential risks, and the outcome. Conclusion The patient is delighted with the result and requested publication of this case to raise awareness of constipation in ALS patients and promote the consideration of colostomy as a treatment option for patients with ileus resistant to conservative management. Ultimately, a multidisciplinary team approach is required to properly assess the risks and benefits to achieve good clinical outcomes.

Clinical Neurology

Life Sciences & Biomedicine

Neurosciences & Neurology

Science & Technology

Details

Title: Subtitle: Colostomy as a definitive treatment in an ALS patient with acute colonic Pseudo-obstruction refractory to medical management, a case report
Creators: Guanghao Liu - University of Iowa Hospitals and Clinics
Jennifer Hrabe - University of Iowa
Rolando Sanchez - University of Iowa
Resource Type: Journal article
Publication Details: BMC neurology, Vol.22(1), 366
DOI: 10.1186/s12883-022-02893-x
PMID: 36138349
PMCID: PMC9494822
NLM abbreviation: BMC Neurol
ISSN: 1471-2377
eISSN: 1471-2377
Publisher: Springer Nature
Number of pages: 5
Language: English
Date published: 09/22/2022
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Surgery; Internal Medicine
Record Identifier: 9984363309202771

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