Abstract
Ogilvie's syndrome (OS) is a functional obstruction of the bowel due to an autonomic imbalance. It often presents with diarrhea and is associated with hypokalemia. We present a case of a 70-year-old male who developed severe abdominal distension, watery diarrhea, and persistent hypokalemia status after left hip arthroplasty after suffering from a femoral neck fracture due to a fall and was diagnosed with OS. The persistent hypokalemia was slow to improve despite aggressive repletion because of the high potassium losses in the stool. This is most likely mediated through the increased expression of BK channels in the colonic mucosa. Aldosterone is theorized to have a role in the regulation of BK channels. Spironolactone was subsequently given and resulted in marked improvement of the diarrhea and hypokalemia. Thus, this case suggests a novel therapeutic approach for the treatment of Ogilvie's syndrome-associated diarrhea and hypokalemia.
Highlights
Ogilvie’s syndrome is primarily a functional obstruction of the bowel
We present a case of Ogilvie’s syndrome-associated diarrhea and hypokalemia that was successfully treated with spironolactone
Most cases present with diarrhea, constipation has been described albeit rarely. It is frequently associated with electrolyte abnormalities like hypokalemia and metabolic acidosis
Summary
Ogilvie’s syndrome is primarily a functional obstruction of the bowel. It has been associated with various electrolyte abnormalities including hypokalemia and metabolic acidosis. Aldosterone antagonists have not been used previously to treat the hypokalemia arising from Ogilvie’s syndrome. We present a case of Ogilvie’s syndrome-associated diarrhea and hypokalemia that was successfully treated with spironolactone.
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