Re: Pseudo-obstruction - Karyn /

[Guest guest]

The term " pseudo " as it is used in pseudo-cysts does not mean

that it doesn't exist or isn't real.....all that means is that in terms of

pathology and histology that it doesn't have the true cellular

components of a cyst as defined by medical science. If I

remember correctly, the pancreatic pseudocyst is lacking a true

cyst wall that is made up of expected cells that are seen in cysts

of other types - like dermoids, breast cysts, etc......Basically the

modifier of " pseudo " is used by medical science to classify the

histology / pathology, in this case it is a " false cysts " even though

grossly it may look and behave like a cyst. Another thing that

comes to mind is the term pseudo-gout. That doesn't mean that

it isn't real (It is a very real and debillitating disease) but that

before we knew what it was on a microscopic or cellular level,

that it was similar to gout but had enough differences to alert the

physicians that it wasn't a true gout. I can attest to the fact that

doctors take pseudo-gout very very seriously because in some

ways, this is a more debillitating disease than gout.

As far as " pseudo-obstruction " , again if I remember right the

information that I have read, it just distinguishes a functional and

/ or intermittent obstruction, one that is not a medical emergency,

from a complete and life threatening obstruction of the bowel. It

is a term that is used to classify a set of symptoms which may

not have a concrete sign (imaging studies come to mind) to back

it up. Pseudo-obstruction can be functional, that is, the nerves

are temporarily misfiring in a small location of the bowel so that

contents are backed up. This is usually relieved after a brief time

period. Functional pseudo-obstruction is hard to diagnose

because you need to do studies during the times that it is

" blocked " and that is hard to predict. The intermittent blockage

due to twisting of the bowels can be diagnosed a little easier by

doing colonscopy or radiology to look for strictures, etc. I was

also told by a resident that the term " obstruction " is being used

incorrectly by both physicians and lay-people so that the term

" pseudo " may be just a reaction to this laziness of use - that is, it

helps to distinguish between the " degrees " of obstruction...from

partial to complete. (I was told that by definition obstruction

means complete blockage......but that we have become lazy and

are substituting obstruction for blockage in that we are using

" partial obstruction " when the correct phrase would be " partial

blockage " - a matter of semantics I guess).

The true obstructions of the bowel are relatively easy to diagnose

(as compared to the intermittent kind) based on the persons

medical history (abdominal surgery, etc), severe symptoms

(usually intense and life threatening) and imaging studies

(usually can pinpoint the area by looking for loops and air as well

as swelling and fluid collections in the peritoneal cavity if the

obstruction has gone on for some time). I know that I am

probably over-simplifying this and may not have all the details

correct but this should give a brief over-view of the phenomenon.

The term " pseudo " doesn't have a judgemental value placed on

it, at least in terms of medical diagnosis in these cases.

However, I am sure that there may be other usages of this term

among medical professionals that are a code for " undeserving "

patients or conditions - a practice that is very unprofessional in

my opinion.

Laurie