Giri S, Krishnamurthy V, Shah D, Joseph A, Korrapati SK, Maharshi S, Sundaram S. Outcome of colonoscopic decompression in acute colonic pseudo-obstruction: A systematic review and meta-analysis. World J Crit Care Med 2025; 14(3): 102733 [DOI: 10.5492/wjccm.v14.i3.102733]
Corresponding Author of This Article
Sudhir Maharshi, MD, Professor, Department of Gastroenterology, SMS Medical College and Hospital, Adarsh Nagar, Jaipur 302004, Rajasthan, India. sudhir.maharshi@gmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Suprabhat Giri, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar 751024, Odisha, India
Veeraraghavan Krishnamurthy, Department of Gastroenterology, NMC Specialty hospital, Al Ain 6222, Abu Dhabi, United Arab Emirates
Devank Shah, Sudhir Maharshi, Department of Gastroenterology, SMS Medical College and Hospital, Jaipur 302004, Rajasthan, India
Abel Joseph, Division of Gastroenterology and Hepatology, Stanford University, Cleveland, OH 94305, United States
Sravan Kumar Korrapati, Department of Gastroenterology, Pinnacle Hospital, Visakhapatnam 530040, Andhra Pradesh, India
Sridhar Sundaram, Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Mumbai 400012, Mahārāshtra, India
Author contributions: Giri S and Sundaram S contributed to the conception and design of the manuscript; Giri S and Maharshi S drafted the initial manuscript; Giri S and Maharshi S contributed to the critical revision of the initial manuscript. All authors contributed to the literature review, analysis, data collection, and interpretation. All the authors approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2021 Checklist, and the manuscript was prepared and revised according to the PRISMA 2021 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sudhir Maharshi, MD, Professor, Department of Gastroenterology, SMS Medical College and Hospital, Adarsh Nagar, Jaipur 302004, Rajasthan, India. sudhir.maharshi@gmail.com
Received: October 28, 2024 Revised: March 10, 2025 Accepted: March 21, 2025 Published online: September 9, 2025 Processing time: 264 Days and 9.7 Hours
Core Tip
Core Tip: Colonoscopic decompression for acute colonic pseudo-obstruction (ACPO) was associated with a pooled success rate of 78.8% after the first session and an overall success rate of 91.5%. The first session of colonoscopic decompression had a significantly higher success than the first dose of neostigmine with OR 3.85. The pooled incidence of perforation remained less than 1%, while one-sixth of the patients had a recurrence after clinical success. Surgery was required in 3.7% of those who had a successful procedure and 10.5% of all cases receiving colonoscopic decompression. In patients undergoing colonoscopic decompression, tube placement should be attempted with the position of the tube at least until the transverse colon to improve clinical success and reduce recurrence. However, the predictors of failure of colonoscopic decompression in ACPO need to be studied further.
