Gangrene and spontaneous perforation of the cecum as a complication of pseudo-obstruction of the colon

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Abstract
Pseudo-obstruction of the colon refers to a condition in which physical and radiologic findings idential to those associated with mechanical obstruction of the large bowel are found, but in which no organic cause of colonic distention can be identified. These cases may involve progressive proximal large-intestinal dilatation to the point of cecal perforation or necrosis. Two cases of spontaneous perforation of the cecum and 1 case of gangrene of the cecum secondary to proximal distention of the right colon that followed pseudo-obstruction of the colon are presented. Various etiologic factors reported in the medical literature are discussed and analyzed, and an anatomicophysiologic explanation of a possible mechanism, based on sympathetic-parasympathetic neurostimulatory imbalance, is offered.

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