Ogilvie's Syndrome Research Articles

Syndrome d’Ogilvie post-césarienne : à propos d’une observation

We report a case of acute postcesarean colonic pseudo-obstruction (Ogilvie's syndrome). We report the treatment algorithm we followed. Recording to this algorithm may improve the treatment of this pathology and perhaps avoid surgical treatment in emergency.

Ogilvie transition to colonic perforation

A pair of 2 serial abdominal images show Ogilvie syndrome in a patient after cardiac surgery with the subtle but classic x-ray transition from a nonperforated to a perforated colon.

Two Cases of Chronic Idiopathic Intestinal Pseudo-obstruction with Different Clinical Features

Chronic intestinal pseudo-obstruction (CIPO) is a rare disorder characterized by a severe impairment of gastrointestinal propulsion in the absence of mechanical obstruction. We experienced a case of chronic pseudo-obstruction in the initial phase mimicking acute pseudo-obstruction, which was treated medically. This ongoing case was compared to another recurrent and intractable case successfully treated with surgery and diagnosed as hypoganglionosis. These two cases showed different clinical features and therapeutic approaches for CIPO; one with the first episode of CIPO mimicking Ogilvie's syndrome; the other with recurrent episodes of CIPO with typical features. In conclusion, CIPO is a difficult disorder with various clinical manifestations and different treatment modalities, therefore individualized diagnostic and therapeutic approaches are needed.

GI Dysmotility: A Case Report

Case Report A 75-year-old male, with a medical history of diabetes, hypertension, coronary artery disease, status post coronary artery bypass graft, and left-sided breast cancer, status post left breast mastectomy, was transferred from an outside hospital with complaints of a month of constipation, nausea and vomiting. The patient presented to an OSH a month prior withrecent onset of constipation, with no bowel movements for 10 days, changed from his usual habit of daily bowel movements. He initially responded to lactulose with a bowel movement andwas discharged on a regimen of stool softeners and laxatives; however, upon returning home, he was again unable to move his bowels despite his bowel regimen and developed diffuse abdominal pain, nausea and vomiting secondary to distension. An outpatient esophagogastroduodenoscopy (EGD) showed that the patient had a normal esophagus and a large amount of retained food in the stomach, concerning for gastroparesis. This finding was thought to be secondary to his diabetes, despitehis well-controlled blood sugars and a hemoglobin A1c of 7.0 %. After two further weeks of constipation, the patient was readmitted to the OSH with abdominal pain, intractable nauseaand vomiting, as well as a 20-25 lbs weight loss since his symptomsbegan. Imaging showed colonic gaseous distention, with the cecum dilated to 9.5 cm, and an un-prepped sigmoidoscopy was performed, showing no inflammation, polyps or masses; ofnote, a screening colonoscopy done 4 months prior identified and removed multiple benign polyps. A CT scan of his abdomenand pelvis also did not show any obstructing colonic masses. Hewas presumed to have colonic pseudo-obstruction, or Ogilvie Syndrome. Erythromycin was started without effect. He was subsequently given neostigmine, which was also unsuccessful inrelieving his symptoms. The patient was then referred to anotherOSH for further workup. A 4-day gut motility study showed a pan-GI dysmotility disorder. Furthermore, a gastric emptying study revealed markedly delayed gastric emptying of both solid and liquid foods, but defecography was entirely normal. Non-contrast CTs of the chest, abdomen and pelvis again did not identify any masses or bowel obstruction, but did show enlarged precarinal lymph nodes and prostatomegaly, as well as small thyroid nodules bilaterally. As the patient continued tofail to have a bowel movement and could not tolerate a diet, he was started on total parenteral nutrition and was transferredto Thomas Jefferson University Hospital (TJUH) for further evaluation.

P297 Acute colonic pseudo-obstruction (ACPO)/Ogilvie's syndrome 2008: a review

P297 Acute colonic pseudo-obstruction (ACPO)/Ogilvie's syndrome 2008: a review

Síndrome de Ogilvie poshisterectomía: reporte de un caso y revisión de la literatura

Objetivo: presentar el estudio y el tratamiento que se le realizó a una mujer embarazada que presentó Síndrome de Ogilvie (SO) como complicación de una histerectomía obstétrica, así como describir la epidemiología,lafisiopatología,loshallazgosclínicos después de los procedimientos gineco-obstétricos y el tratamiento de esta patología mediante una revisión de la literatura.Presentación del caso: mujer de 28 años de edad con embarazo de 38 semanas de gestación quien después de parto vaginal eutócico sufrió atonía uterina. Debido a la falta de mejoría con el manejo médico, se le realizó una histerectomía abdominal subtotal, presentando picos febriles, intolerancia a la vía oral, taquicardia, distensión e hipertimpanismo abdominal con dolor a la palpación superficial y profunda en hemiabdomen derecho y peristaltismo disminuido durante el posoperatorio. La radiografía de abdomen evidenció un cuadro obstructivo con origen probable a nivel del intestino delgado, por lo que se le practicó una laparotomía exploratoria donde se le encontró peritonitis fecal y perforación colónica a nivel de la válvula ileocecal, sin evidencia de obstrucción mecánica.Discusión: el SO se caracteriza por la dilatación masiva y progresiva del colon en ausencia de una obstrucción mecánica. Se desarrolla principalmente en pacientes hospitalizadas con graves condiciones médico-quirúrgicas, pero también se presenta frecuentemente después de procedimientos gineco-obstétricos. Debido a que este síndrome se ha visto asociado con una alta morbimortalidad, es necesario que el gineco-obstetra lo tenga en cuenta como diagnóstico diferencial y esté atento a su presentación como complicación de cirugías obstétricas o ginecológicas.

Ogilvie's syndrome, beta-blockers and burns.

Ogilvie's syndrome, beta-blockers and burns.

Constipação intestinal em terapia intensiva

Constipation is a common complication identified among critically ill patients. Its incidence is highly variable due to lack of definition of such patients. Besides the already known consequences of constipation, in recent years it was observed that this complication may also be related to worse prognosis of critically ill patients. This review endeavors to describe the main available scientific evidence showing that constipation is a prognostic marker and a clinical representation of intestinal dysfunction, in addition to eventually interfering in the prognosis with treatment. Ogilvie syndrome, a major cause of morbidity and mortality in intensive care units was also reviewed. Considering the above cases it was concluded that more attention to this disorder is required in intensive care units as well as development of protocols for diagnosis and management of critically ill patients.

Acute colonic pseudo-obstruction (Ogilvie's syndrome): radiologic diagnosis and medical treatment with neostigmine. Report of 4 cases

Acute colonic pseudo-obstruction (Ogilvie's syndrome): radiologic diagnosis and medical treatment with neostigmine. Report of 4 cases

Akute Pseudoobstruktion des Kolons, „Ogilvie-Syndrom“, eine lebensbedrohliche Komplikation nach Implantation von Hüfttotalendoprothesen

In the literature, an acute colonic pseudo-obstruction (Ogilvie's syndrome) is frequently observed as a complication after hip arthroplasty. It results in a massive colon dilatation without mechanical obstructions and can lead to a life-threatening colon perforation with a high mortality. We report on a 81-year-old male patient who suffered from an acetabular fracture after falling down with a concomitant coxarthrosis at the same hip side. A total hip arthroplasty was performed using a Müller cap. Postoperatively, he developed an acute colonic pseudo-obstruction that was treated conservatively with multiple colonoscopic decompressions. The importance of prompt recognition, careful monitoring and appropriate management to reduce morbidity and mortality are supported by this case. Early diagnosis and colonoscopic decompressions play a key role in the therapy for Ogilvie's syndrome. In case of a failure of conservative treatment or peritonism, an early laparotomy and coecostomy are necessary.

Ogilvie Syndrome and Herpes Zoster: Case Report and Review of the Literature

The very unusual association between herpes zoster and Ogilvie syndrome has received scant attention in the published literature. This review discusses the published experience since 1950 and attempts to increase clinical awareness about the co-existence of both conditions. An 84-year-old male patient affected by herpes zoster presented with advanced acute colonic pseudo-obstruction and was successfully treated with colonic diversion. Twenty published studies (1950-2008) of 28 patients in whom the two conditions co-existed are reviewed. The review included 22 male and 7 female patients (24%) aged 32-87 years (mean, 61 years). Significant co-morbidities were present in 45% of the patients. The majority of patients were observed and treated conservatively (83%). Two patients died (7%), both suffering from respiratory complications and malignancy. Recognition of the combined syndrome may help to avoid unnecessary surgery. Laparotomy should be reserved as a last resort for when the obstruction cannot be successfully managed by endoscopy. A diverting colostomy can be used to monitor the blood supply and thus provide early warning for an impending abdominal catastrophe.

Ogilvie's syndrome with caecal perforation after Caesarean section: a case report

IntroductionOgilvie's syndrome describes the phenomenon of an acute colonic pseudo-obstruction without a mechanical cause. It is rare but has been reported to occur after Caesarean section. It can lead to bowel perforation or ischaemia.Case presentationA healthy, 28-year-old Caucasian woman presented 2 weeks past her expected date of delivery for her first pregnancy. She underwent an uncomplicated elective Caesarean section but developed abdominal pain and bloating postoperatively and was subsequently diagnosed with acute colonic pseudo-obstruction, also known as Ogilvie's syndrome.ConclusionThis case report highlights the rare, but potentially dangerous, diagnosis of Ogilvie's syndrome after Caesarean section. It is of particular interest to obstetricians, midwifery staff and general surgeons and shows the importance of accurate diagnosis, regular abdominal reassessment and early senior input to ensure appropriate and rapid treatment.

Ogilvie syndrome: Staff awareness and senior input is vital for early diagnosis

Ogilvie syndrome: Staff awareness and senior input is vital for early diagnosis

Acute colonic pseudoobstruction in a child with sickle cell disease treated with neostigmine

Sickle cell disease is a disorder that produces significant morbidity and mortality. Vaso-occlusive pain crises are the most common presenting symptom associated with sickle cell patients. A rare, yet important to recognize, complication of sickle cell disease is acute colonic pseudoobstruction, also known as Ogilvie's syndrome. These patients may present with symptoms that are difficult to distinguish from other etiologies of abdominal pain, but a thorough diagnostic workup can provide important clues. Furthermore, there is no agreement on optimal treatment of pseudoobstruction. We report the first pediatric case of acute pseudoobstruction secondary to sickle cell disease that was treated successfully with neostigmine. Early recognition of this phenomenon is important as it alters patient management, can be treated medically, and may avoid unnecessary surgical intervention.

A systematic review of medical diagnosis of Ogilvie's syndrome in childbearing

Objective to review all published papers examining medical diagnosis of Ogilvie's syndrome and pregnancy with a view to assessing the implications of the diagnosis and the condition itself for childbearing women, midwives and medical practitioners. Design systematic review. Search strategy MEDLINE, CINAHL, EMBASE, Web of Science and Cochrane databases were searched from 1950 to 2006 inclusive. Papers were read by two independent researchers and selected if they informed the link between Ogilvie's syndrome and childbearing or were concerned with other aspects of maternal mortality. Findings 23 papers fulfilled the selection criteria and were of a suitable standard. Inconsistencies in relation to the diagnosis of Ogilvie's syndrome were noted, and an increase in maternal deaths from this condition was reported up to 2002. Key conclusions this paper highlights the strengths and weaknesses of medical diagnosis, as exemplified by Ogilvie's syndrome. The scientific basis of diagnoses such as Ogilvie's syndrome may deserve attention. This diagnosis has been shown to be unstable, both in temporal and aetiological terms. The midwifery and nursing reaction to the abrupt appearance of this condition is, at best, unfortunate. The attribution of blame to midwifery practices is deserving of a more robust response. Implications for practice there may be clinical implications of the diagnosis of Ogilvie's syndrome for other aspects of maternity (including any nursing) care. A particularly significant area is the widely recognised increase in the caesarean rate with which Ogilvie's syndrome has been closely linked.

Acute colonic pseudo‐obstruction (Ogilvie syndrome) with Chilaiditi syndrome

Medical Journal of AustraliaVolume 189, Issue 1 p. 42-42 Snapshot Acute colonic pseudo-obstruction (Ogilvie syndrome) with Chilaiditi syndrome Shobhit Mathur, Corresponding Author Shobhit Mathur Intern drshobhitmathur@yahoo.co.in Government Medical College and SSG Hospital, Vadodara, Gujarat, India.Correspondence: drshobhitmathur@yahoo.co.inSearch for more papers by this authorOm J Lakhani, Om J Lakhani Intern Government Medical College and SSG Hospital, Vadodara, Gujarat, India.Search for more papers by this authorVirsing P Hathila, Virsing P Hathila Superintendent, Professor and Head of Surgery Government Medical College and SSG Hospital, Vadodara, Gujarat, India.Search for more papers by this authorDipesh D Duttaroy, Dipesh D Duttaroy Associate Professor Government Medical College and SSG Hospital, Vadodara, Gujarat, India.Search for more papers by this authorAnis S Vohra, Anis S Vohra Assistant Professor Government Medical College and SSG Hospital, Vadodara, Gujarat, India.Search for more papers by this authorHimesh R Chauhan, Himesh R Chauhan Assistant Professor Government Medical College and SSG Hospital, Vadodara, Gujarat, India.Search for more papers by this author Shobhit Mathur, Corresponding Author Shobhit Mathur Intern drshobhitmathur@yahoo.co.in Government Medical College and SSG Hospital, Vadodara, Gujarat, India.Correspondence: drshobhitmathur@yahoo.co.inSearch for more papers by this authorOm J Lakhani, Om J Lakhani Intern Government Medical College and SSG Hospital, Vadodara, Gujarat, India.Search for more papers by this authorVirsing P Hathila, Virsing P Hathila Superintendent, Professor and Head of Surgery Government Medical College and SSG Hospital, Vadodara, Gujarat, India.Search for more papers by this authorDipesh D Duttaroy, Dipesh D Duttaroy Associate Professor Government Medical College and SSG Hospital, Vadodara, Gujarat, India.Search for more papers by this authorAnis S Vohra, Anis S Vohra Assistant Professor Government Medical College and SSG Hospital, Vadodara, Gujarat, India.Search for more papers by this authorHimesh R Chauhan, Himesh R Chauhan Assistant Professor Government Medical College and SSG Hospital, Vadodara, Gujarat, India.Search for more papers by this author First published: 07 July 2008 https://doi.org/10.5694/j.1326-5377.2008.tb01895.xCitations: 4Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume189, Issue1July 2008Pages 42-42 RelatedInformation

Postpolypectomy acute colonic pseudo-obstruction (Ogilvie's syndrome)

Postpolypectomy acute colonic pseudo-obstruction (Ogilvie's syndrome)

Life-Threatening Clozapine-Induced Gastrointestinal Hypomotility

To raise awareness of potentially lethal clozapine-induced gastrointestinal hypomotility (CIGH) by reviewing cases from the literature and unpublished pharmacovigilance data and to offer strategies aimed at prevention and early treatment. Databases (PsycINFO, 1967-2007; MEDLINE, 1950-2007; and EMBASE, 1988-2007) were searched using the term clozapine together with each of the following: gastrointestinal, dysmotility, constipation, obstipation, fecal impaction, fecaloma, paralytic ileus, adynamic ileus, subileus, ischemic colitis, colon ischemia, bowel ischemia, gastrointestinal ischemia, gut ischemia, obstruction, necrosis, gangrene, bowel perforation, micro-perforation, megacolon, toxic megacolon, acquired megacolon, pseudo-obstruction, Ogilvie, and Ogilvie's syndrome. We analyzed the electronic database entries held by the Adverse Drug Reactions Advisory Committee and the New Zealand Intensive Medicines Monitoring Program, which cited suspected clozapine-related gastrointestinal side effects, as well as all relevant published case reports. We reviewed the literature on the treatment of gastrointestinal hypomotility and constipation. We compiled a database of 102 cases of suspected life-threatening CIGH. There was a mortality rate of 27.5% and considerable morbidity, largely due to bowel resection. Within Australasia, at least 15 patients have died of CIGH. Probable risk factors are identified as recent instigation of clozapine, high clozapine dose or serum level, concomitant anticholinergic use, or intercurrent illness. The paucity of literature on CIGH suggests that the significance of this uncommon but important and frequently fatal side effect has not been recognized. Clozapine can affect the entire gastrointestinal system, from esophagus to rectum, and may cause bowel obstruction, ischemia, perforation, and aspiration. The mechanism is likely to be anticholinergic and antiserotonergic. Clozapine prescribing should be accompanied by regular physical monitoring, appropriate and timely use of laxatives, and early referral of constipated patients--before life-threatening pathologic processes develop.

Secretory diarrhoea with high faecal potassium concentrations: A new mechanism of diarrhoea associated with colonic pseudo-obstruction? Report of five patients

To report the mechanism of diarrhoea in patients with subacute colonic pseudo-obstruction, profuse secretory diarrhoea and hypokalemia. Five consecutive patients who developed colonic pseudo-obstruction, profuse watery diarrhoea and severe hypokalemia. Investigations excluded mechanical intestinal obstruction. Usual cause of diarrhoea were ruled out. Abdominal distension and diarrhoea improved simultaneously in all cases after colonoscopic decompression or intravenous neostigmine. Faecal ionograms showed a low osmotic gap and high faecal potassium concentration explaining the hypokalemia: 100 to 180 mEq/kg (usually inferior than 50 mEq/l in case of secretory diarrhoea) and low faecal sodium concentrations. Potassium salts were the only factor identified as the driving osmotic force for the diarrhoea. Secretory diarrhoea is classically due to chloride active secretion with passive sodium secretion or to inhibition of sodium absorption. In five cases of Ogilvie's syndrome we evidenced an original mechanism of secretory diarrhoea due to active potassium secretion responsible of a profound hypokalemia. This novel type of diarrhoea may be a hallmark of colonic pseudo-obstruction due to colonic distension.

Colonic Pseudo-Obstruction

Acute colonic pseudo-obstruction (Ogilvie's syndrome) is a disorder characterized by gross dilatation of colon in the absence of an obstructing anatomic lesion. The precise etiology by which colonic dilation occurs is not fully under- stood. It generally develops in hospitalized patients and is associated with a wide variety of medical and surgical condi- tions. Most cases respond to conservative management. We describe a case of a 42 year old female with massive colonic dilation and no obstructing lesions. She developed respiratory failure due to severe abdominal distension. Overnight na- sogastric decompression along with repletion of potassium led to complete resolution of abdominal distension and respira- tory failure. A 42-year-old female with developmental delay and self- abusive (self injury and self mutilating) behavior presented to the emergency room with increasing abdominal distention of four days duration. On physical examination the patient was afebrile but in severe respiratory distress requiring en- dotracheal intubation. The abdomen was severely distended and minimally diffusely tender. Significant laboratory find- ings were a white blood cell count of 14,000 per cubic mil- limeter and potassium of 3.3 mEq/l. Abdominal radiographs revealed massively dilated loops of large bowel (Fig. 1). A computed tomographic scan showed collapsed small bowel with abrupt transition to markedly dilated large bowel (Fig. 2). A colonoscopy re- vealed collapsed sigmoid colon up to 50cm, at which point the bowel became massively dilated. No obstructing lesions were seen.