Case Report: Acupuncture for acute colonic pseudo- obstruction in a 90-year-old patient with COVID-19 infection.

Introduction: Acute colonic pseudo-obstruction (ACPO) is a severe gastrointestinal motility disorder defined by significant dilation of the colon without any mechanical blockage. In recent years, studies have shown that ACPO, as a rare complication of severe COVID-19, requires prolonged ICU treatment and still carries an extremely high risk. Recent reports indicate that patients with severe COVID-19 are at an increased risk of developing complications, including ACPO. These patients often require extended treatment in the intensive care unit and may undergo multiple drug therapies. Despite aggressive treatment efforts, their mortality risk remains elevated. Methods: We use the acupuncture points selected under the guidance of traditional Chinese medicine theory, combined with the application of 5 Hz electroacupuncture. Results: In a 90-year-old male, severe COVID-19 developed acute colonic pseudo-obstruction (ACPO). Despite fasting, gastrointestinal decompression, enema, and other life support measures, ACPO further deteriorated. Six days after admission, the patient's abdominal girth has increased to 93 cm. At last, we decided to use acupuncture. One hour after acupuncture, the patient began to defecate. From then on, acupuncture treatment was carried out daily, and the patient defecated regularly. On the third day after the acupuncture treatment, the patient began to receive a small amount of enteral nutrition. Nine days after starting acupuncture, a CT scan confirmed that there was no intestinal obstruction. Conclusion: Early acupuncture intervention appears safe and effective for ACPO, particularly in elderly patients with surgical contraindications. This case suggests that pattern differentiation-guided point selection and frequency-specific electroacupuncture are critical determinants of therapeutic efficacy.