Applegarth_2026_Surg.Clin.North.Am_106_153

Colonic pseudo-obstruction is often secondary to disturbances in the enteric nervous system and can be difficult to treat definitively. Treatment options primarily focus on conservative measures and medical management with acetylcholinesterase inhibitors. Surgeons should feel comfortable with endoscopic decompression when necessary. Rarely, acute colonic pseudo-obstruction will require surgery because of impending perforation, and it is imperative that surgeons recognize indications for operative intervention.