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Main differences between mechanical versus functional intestinal obstruction

	Mechanical obstruction	POI	AIPO/ACPO	CIPO
Luminal obstruction	Yes	No	No	No
Motility	Initially ↑ then ↓ proximal to obstruction	↓	↓/uncoordinated	↓/uncoordinated
Dilatation	Yes (proximal to obstruction)	No	Yes	Yes
GI involvement	Proximal to obstruction	Mainly small bowel	Mainly colon	Pan-enteric
Radiology	Typical "cut-off" point; presence of air-fluid levels	"Cut-off point" occasionally present; air-fluid levels usually absent	"Cut-off point" occasionally present; air-fluid levels sometimes detected	"Cut-off point" occasionally present; air-fluid levels detectable
Course	Acute	Acute	Acute	Chronic
Progression	Rapidly evolving toward total obstruction	Self-limiting, slowly improving	May respond to medical treatment; major complication may occur	Variable, generally self-limiting
Treatment	Surgery	Supportive measures	Medical treatment (neostigmine); decompressive endoscopy or surgery in unresponsive cases	Variable; EN, TPN/HPN often needed

↑: increased; ↓: decreased; AIPO/ACPO: acute intestinal pseudo-obstruction/acute colonic pseudo-obstruction; CIPO: chronic intestinal pseudo-obstruction; EN: enteral nutrition; GI: gastrointestinal; POI: postoperative ileus; TPN/HPN: total/home parenteral nutrition.

Reproduced from: De Giorgio R, Cogliandro RF, Barbara G, et al. Chronic intestinal pseudo-obstruction: clinical features, diagnosis, and therapy. Gastroenterol Clin North Am 2011; 40:787. Table used with the permission of Elsevier Inc. All rights reserved.

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