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Ogilvie Syndrome or Acute Colonic Pseudo-Obstruction
Published in Stephen M. Cohn, Peter Rhee, 50 Landmark Papers, 2019
Matthew J. Forestiere, Kenji Inaba
Ogilvie syndrome, or acute colonic pseudo-obstruction, is a syndrome marked by massive colonic dilation without mechanical obstruction. The clinical history is important to consider as it usually occurs in patients who tend to be debilitated, with prolonged hospitalizations or a variety of contributing medical conditions and pelvic or spinal pathology. Despite this, with conservative treatment alone, it is reported that up to 30%–50% of patients will resolve within 3 days (Vanek and Al-Salti, 1986, Tsirline et al., 2012; Peker et al., 2017). Patients with persistent obstruction after conservative management should progress to the next treatment modality, as the risk of perforation increases after 3 days. The only randomized, double-blinded data available for a treatment modality is the use of neostigmine, which to this day remains a very safe, practical, and cost-effective treatment. The administration of neostigmine is not without side effects, and administration should be in a monitored setting. There is a role for colonoscopic decompression in patients who do not respond to conservative management or neostigmine therapy. Surgery should be reserved as the last treatment option for those with evidence of peritonitis, ischemia, or perforation.
Large Bowel Obstruction
Published in Stephen M. Cohn, Matthew O. Dolich, Kenji Inaba, Acute Care Surgery and Trauma, 2016
Colonic pseudo-obstruction, or Ogilvie syndrome, should be viewed as a separate disease entity. It involves massive colonic dilation without true mechanical obstruction. The etiology is thought to be related to autonomic imbalance leading to a disturbance of the efferent parasympathetic output of the sacral spinal segments S2–S4 to the distal colon. Initial therapy is similar to mechanical obstruction with fluid resuscitation, nil per os (NPO) and possibly decompression in the form of nasogastric suction and/or rectal tube decompression. However, it is imperative to exclude true colonic obstruction as the subsequent management strategies can vary widely.
The rare Ogilvie’s Syndrome in pregnancy. How to manage? A case report and literature review
Published in Journal of Obstetrics and Gynaecology, 2022
Vittorio Bresadola, Pier Paolo Brollo, Michele Graziano, Carlo Biddau, Tommaso Occhiali, Lorenza Driul
The literature review has been conducted by two independent reviewers (M.G. and P.P.B) on the PubMed and Scopus databases. The terms used for the search were as follows: ‘Ogilvie’, ‘Syndrome’ OR ‘acute colonic pseudo-obstruction’, ‘acute pseudo-obstruction’ AND ‘Pregnancy’. The research was closed on the 20th of June 2020. One hundred forty-one records were retrieved and reviewed by the two reviewers to exclude any duplicate publications. Only cases of OS arising during pregnancy, in the absence of further confounding conditions, were considered (Figure 3). All cases of OS in the gynecological or obstetrics field related to events such as childbirth, surgery, or placenta previa were therefore excluded. In this way six articles, all describing a single case report, were considered relevant to the search query (Imai et al. 1990; Nishida et al. 1993; Pecha and Danilewitz 1996; Rieger et al. 1996; Tung et al. 2008; Kim et al. 2012) (Table 2).