Clin Colon Rectal Surg 2005; 18(2): 96-101
DOI: 10.1055/s-2005-870890
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Acute Intestinal Pseudo-Obstruction (Ogilvie's Syndrome)

Nell Maloney1 , H. David Vargas1 , 2
  • 1Department of Surgery, Eastern Virginia Medical School, Norfolk, Virginia
  • 2Tidewater Surgical Specialists, Colorectal Division, Chesapeake, Virginia
Further Information

Publication History

Publication Date:
24 May 2005 (online)

ABSTRACT

Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome, is a condition characterized by massive colonic distension in the absence of mechanical obstruction. Patients presenting with Ogilvie's syndrome have underlying medical and surgical conditions predisposing them to the syndrome. Ogilvie's syndrome can often be managed by conservative therapy. However, unrecognized and untreated, the continued distension associated with Ogilvie's syndrome can lead to perforation that is associated with a high mortality rate. In this article, the pathophysiology, epidemiology, and treatment options are reviewed.

REFERENCES

  • 1 Ogilvie W H. Large intestine colic due to sympathetic deprivation: a new clinical syndrome.  Br Med J. 1948;  2 671-673
  • 2 Saunders M D, Kimmey M B. Colonic pseudo-obstruction: the dilated colon in the ICU.  Semin Gastrointest Dis. 2003;  14 20-27
  • 3 Law N M, Bharucha A E, Undale A S, Zinmeister A R. Cholinergic stimulation enhances colonic motor activity, transit, sensation in humans.  Am J Physiol Gastrointest Liver Physiol. 2001;  281 G1228-G1237
  • 4 Ponec R J, Saunders M D, Kimmey M B. Neostigmine for the treatment of acute colonic pseudo-obstruction.  N Engl J Med. 1999;  341 137-141
  • 5 Tenofsky P L, Beamer R L, Smith R S. Ogilvie syndrome as a postoperative complication.  Arch Surg. 2000;  135 682-687
  • 6 Vanek V W, Al-Salti M. Acute pseudo-obstruction of the colon (Ogilvie's syndrome): an analysis of 400 cases.  Dis Colon Rectum. 1986;  29 203-210
  • 7 Moons V, Coremans G, Tack J. An update on acute colonic pseudo-obstruction (Ogilvie's syndrome).  Acta Gastroenterol Belg. 2003;  66 150-153
  • 8 Anuras S, Shirazi S S. Colonic pseudo-obstruction.  Am J Gastroenterol. 1984;  79 525-531
  • 9 Delgado-Aros S, Camilleri M. Pseudo-obstruction in the critically ill.  Best Pract Res Clin Gastroenterol. 2003;  17 427-444
  • 10 Schermer C R, Hanosh J J, Davis M, Pitcher D E. Ogilvie's syndrome in the surgical patient: a new therapeutic modality.  J Gastrointest Surg. 1999;  3 173-177
  • 11 Geller A, Petersen B T, Gostout C J. Endoscopic decompression for acute colonic pseudo-obstruction.  Gastrointest Endosc. 1996;  44 144-150
  • 12 Hutchinson R, Griffiths C. Acute colonic pseudo-obstruction: a pharmacologic approach.  Ann R Coll Surg Engl. 1992;  74 364-367
  • 13 Amaro R, Rogers A I. Neostigmine infusion: new standard of care for acute colonic pseudo-obstruction?.  Am J Gastroenterol. 2000;  95 304-305
  • 14 Trevisani G T, Hyman N H, Church J M. Neostigmine: safe and effective treatment for acute colonic pseudo-obstruction.  Dis Colon Rectum. 2000;  43 599-603
  • 15 Loftus C G, Harewood G C, Baron T H. Assessment of predictors of response to neostigmine for acute colonic pseudo-obstruction.  Am J Gastroenterol. 2002;  97 3118-3122
  • 16 Stephenson B M, Morgan A R, Salaman J R, Wheeler M H. Ogilvie's syndrome: a new approach to an old problem.  Dis Colon Rectum. 1995;  38 424-427
  • 17 Turego-Fuentes F, Munoz-Jiminez F, Del Valle-Hernandez E et al.. Early resolution of Ogilvie's syndrome with intravenous neostigmine.  Dis Colon Rectum. 1997;  40 1353-1357
  • 18 Eisen G M, Baron T H, Dominitz J A et al.. Acute colonic pseudo-obstruction.  Gastrointest Endosc. 2002;  56 789-792
  • 19 MacColl C, MacCannell K L, Baylis B, Lee S S. Treatment of acute colonic pseudoobstruction with cisapride.  Gastroenterology. 1990;  98 773-776
  • 20 Lee J T, Taylor B M, Singleton B C. Epidural anesthesia for acute pseudo-obstruction of the colon (Ogilvie's syndrome).  Dis Colon Rectum. 1988;  31 686-691
  • 21 Kukora J S, Dent T L. Colonic decompression of massive nonobstructive cecal dilation.  Arch Surg. 1977;  112 512-517
  • 22 Gosche J R, Sharpe J N, Larson G M. Colonoscopic decompression for pseudo-obstruction of the colon.  Am Surg. 1989;  55 111-115
  • 23 Bode W E, Beart R W, Spencer R J, Culp C E, Wolff B G, Taylor B M. Colonoscopic decompression for acute pseudo-obstruction of the colon (Ogilvie's syndrome).  Am J Surg. 1984;  147 243-245
  • 24 Nano D, Prindiville T, Pauly M, Chow H, Ross K, Trudeau W. Colonoscopic therapy of acute pseudoobstruction of the colon.  Am J Gastroenterol. 1987;  82 145-148
  • 25 Groff W. Colonoscopic decompression and intubation of the cecum for Ogilvie's syndrome.  Dis Colon Rectum. 1985;  26 503-506
  • 26 Rex D K. Acute colonic pseudo-obstruction (Ogilvie's syndrome).  Gastroenterologist. 1994;  2 233-238
  • 27 Sariego J, Matsumoto T, Kerstein M D. Colonoscopically guided tube decompression in Ogilvie's syndrome.  Dis Colon Rectum. 1991;  34 720-722
  • 28 Fausel C S, Goff J S. Nonoperative management of acute idiopathic colonic pseudo-obstruction (Ogilvie's syndrome).  West J Med. 1985;  143 50-54
  • 29 Corman M L. Colon and Rectal Surgery. 4th ed Philadelphia; Lippincott-Williams and Wilkins 1998
  • 30 Duh Q Y, Way L W. Diagnostic laparoscopy and laparoscopic cecostomy for colonic pseudo-obstruction.  Dis Colon Rectum. 1993;  36 65-70
  • 31 Casola G, Withers C, vanSonnenberg E, Herba M J, Saba R M, Brown R A. Percutaneous cecostomy for decompression of the massively distended cecum.  Radiology. 1986;  158 793-794
  • 32 Benacci J C, Wolff B G. Cecostomy: therapeutic indications and results.  Dis Colon Rectum. 1995;  38 530-534
  • 33 Ramage J I, Baron T H. Percutaneous endoscopic cecostomy: a case series.  Gastrointest Endosc. 2003;  57 752-755

H. David VargasM.D. 

Colorectal Division-Tidewater Surgical Specialists

3205 Churchland Blvd., Chesapeake, VA 23321

Email: dv700@aol.com

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