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Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2016, Number 4

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Rev Esp Med Quir 2016; 21 (4)

Acute pseudo-obstruction of the colon (Ogilivie’s syndrome): case report and current management

Morfín-Meza KE, Gutiérrez-Alfaro C, Andrade-Arróniz LE, Evaristo-Méndez G

Language: Spanish
References: 14
Page: 165-171
PDF size: 166.65 Kb.


ABSTRACT

Background: Acute pseudo-obstruction of the colon is characterized by massive distension of the large intestine in the absence of mechanical obstruction. We present a patient with abdominal sepsis and this colopathy, also known as Ogilvie’s syndrome.
Clinical cases: A man of 78 years old, with a history of chronic obstructive pulmonary disease, presented surgical site and the mesh infection used to repair a post-incisional hernia. He later developed Ogilvie’s syndrome which was managed conservatively and then underwent three surgeries. The patient died two months of hospital admission for nosocomial pneumonia. In the case we presented no neostigmine was administered or endoscopic instrumentation was performed. The management of patients with acute pseudo-obstruction of the colon should be done in hospitals with all the resources necessary to treat this disease.
Conclusions: Conservative management of Ogilvie’s syndrome is satisfactory in most patients, while colonoscopic decompression is reliable when drug therapy fails to resolve the intestinal distension. Surgery is indicated when previous therapies fail or when there is evidence of ischemia or peritonitis and perforation of the colon.


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