Surgical intervention: surgery was indicated when colonic diatension lasted more than 6 days, or obvious cecal distention (diameter > 10 cm) continued after 48-72 hs of conservative management and colonoscopic decompression ???or with contradiction of colonoscopy. ileostomy was performed under epidural or local anesthesia by a team of experienced surgeons. If the patients had colonic necrosis or perforation, ileostomy was superseded by colectomy under general anesthesia.