Ogilvie’s Syndrome – Acute Colonic Pseudo-Obstruction. Case report and Review of the Literature

Stefan Georgescu1, Liviu Dubei1, Mihael Zaharia1, Ciprian Cîrdei1, Felicia Crumpei2, Cristina Cijevschi-Prelipcean3, Maria Stoian4

1) 1st Surgical Clinic. 2) Radiology Clinic. 3) 2nd Medical Clinic Gastroenterology, University of Medicine and Pharmacy, Pathology Department, St. Spiridon Hospital, Iasi. 4) Department of Intensive Care, Parhon Hospital, Iasi

Abstract

We present a rare entity of colonic pseudo-obstruction, characterised by severe colonic dilatation in absence of any organic obstacle. Clinical symptoms, diagnostic approach, and therapeutic measures are analysed and discussed. Many factors have been associated with this syndrome which include electrolyte imbalance, systemic infection, drugs, and occasionally, neurologic disease. Reported here is a case of acute colonic pseudo-obstruction which developed in a patient with restrictive respiratory dysfunction. Colonic decompression by means of colonoscopy, the most effective therapeutic approach for pseudo - obstruction failed, and surgical cecostomy was required.

The acute colonic pseudo-obstruction, Ogilvie’s Syndrome, most often appears as a complication of other clinical conditions. It is characterized by massive colonic dilatation in the absence of a mechanical cause and may lead to cecal perforation in absence of treatment. When colonic obstruction is suspected, one should always consider the possibility of the occurrence of Ogilvie’s syndrome.

Key words

Ogilvie’s syndrome – acute colic pseudo-oclusion – neostigmine – cecostomy