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Acute colonic pseudo-obstruction

Masoomeh Khajehnoori, Sonal Nagra
Ogilvie syndrome or acute colonic pseudo-obstruction is characterized by acute dilatation of the colon usually involving caecum and right hemi-colon in the absence of any mechanical obstruction. It is usually associated with an underlying severe illness/infection or surgery, mostly caesarean section and rarely occurs spontaneously. Identification of this condition is important due to the increased risk of bowel ischaemia and perforation particularly with caecal diameter >9 cm. This is a case report of bowel perforation following caesarean section leading to urgent laparotomy...
2016: Journal of Surgical Case Reports
K D Peker, M Cikot, M A Bozkurt, B Ilhan, B Kankaya, S Binboga, H Seyit, H Alis
BACKGROUND: Performance of urgent colonoscopy for the purposes of diagnosis and treatment of Ogilvie's syndrome remains controversial. However, no trials have directly compared neostigmine with endoscopic therapy. This study aimed to compare the effect of neostigmine and colonoscopic decompression in the treatment of Ogilvie's syndrome. METHODS: This study was designed as a retrospective, non-randomized clinical study of sequential patients. Patients who were diagnosed as having acute colonic pseudo-obstruction were separated into two groups after conservative treatment...
July 18, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Q Niu, K Liang, C Zhang
Acute colonic pseudo-obstruction is known as Ogilvie's syndrome with marked colonic distension in the absence of any mechanical obstruction. The mechanism of this disease is still unclear. Acute colonic pseudo-obstruction may be caused by infection, traumatic disease, post-operation or neurological disease. The index patient presented with acute colonic pseudo-obstruction secondary to acute gastroenteritis. She responded to conservative treatment including diet restriction, gastrointestinal decompression, intravenous fluid and electrolyte supplement...
December 10, 2015: West Indian Medical Journal
Jon D Vogel, Daniel L Feingold, David B Stewart, Jacquelyn S Turner, Marylise Boutros, Jonathan Chun, Scott R Steele
No abstract text is available yet for this article.
July 2016: Diseases of the Colon and Rectum
Fatih Mehmet Yazar, Burhan Hakan Kanat, Seyfi Emir, Mehmet Buğra Bozan, Yılmaz Bilgiç, Abdurrahman Şahin, Fatih Erol, Zeynep Özkan, Evrim Gül, Aykut Urfalioğlu
PURPOSE: Colonic pseudo obstruction disease commonly seen in the elderly, immobile patient group can cause serious mortality and morbidity. Our objective in this retrospective study is to share our clinical experience by evaluating patients with Ogilvie syndrome who were followed and treated in our clinic. METHODS: Eleven cases with the diagnosis of Ogilvie syndrome followed up and treated between September 2010 and April 2013 were evaluated retrospectively. All the patients that had no symptoms of acute abdominal pain were initiated conservative treatment...
March 2016: Indian Journal of Critical Care Medicine
Michelle M Dodds, Callum D Frazer, Jeffrey Lipman, Michael Reade
No abstract text is available yet for this article.
March 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Jeung Hui Pyo, Yang Won Min, Poong-Lyul Rhee
Neostigmine can successfully decompress patients with acute colonic pseudo-obstruction (ACPO) who are unresponsive to conservative therapy. However, neostigmine is contraindicated in renal failure, so it is underused in ACPO patients with renal failure who would be otherwise appropriate candidates. We described the first successfully treated case of acute kidney injury (AKI) with neostigmine in a patient with ACPO. A 72-year-old man who underwent a coronary artery bypass graft surgery 11 days prior presented to the emergency room with abdominal distension, peripheral edema, and dyspnea on exertion...
February 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Samuel W Ross, Bindhu Oommen, Blair A Wormer, Amanda L Walters, Vedra A Augenstein, B Todd Heniford, Ronald F Sing, A Britton Christmas
Acute colonic pseudo-obstruction (ACPO) is a rare but often fatal disease. Herein, we present the largest study to date on ACPO. The National Inpatient Sample was queried for ACPO diagnoses from 1998 to 2011. Patients were analyzed by treatment into four groups: medical management (MM), colonoscopy alone [(endoscopy-only group) ENDO], surgery alone (SURG), or surgery and colonoscopy (SAC). Logistic regression was used to identify predictors of adverse outcomes by treatment group. There were 106,784 cases of ACPO: 96,657 (90...
February 2016: American Surgeon
J W G Ng, S A Cairns, C P O'Boyle
BACKGROUND: Burn produces complex gastrointestinal (GI) responses. Treatment, including large volume fluid resuscitation and opioid analgesia, may exacerbate GI dysfunction. Complications include constipation and opioid-induced bowel dysfunction (OBD), acute colonic pseudo-obstruction (ACPO), bacterial translocation and sepsis, and abdominal compartment syndrome (ACS). Contamination of perineal burns contributes to delayed healing, skin graft failure and sepsis and may impact upon morbidity and mortality...
June 2016: Burns: Journal of the International Society for Burn Injuries
Edgar Núñez-García, Luis César Valencia-García, Ricardo Sordo-Mejía, Daniel Kajomovitz-Bialostozky, Alberto Chousleb-Kalach
BACKGROUND: Acute pseudo-obstruction of the colon is a disorder characterised by an increase in intra-luminal pressure that leads to ischaemia and necrosis of the intestinal wall. The mechanism that produces the lesion is unknown, although it has been associated with: trauma, anaesthesia, or drugs that alter the autonomic nervous system. The pathophysiology of medication induced colon toxicity can progress to a perforated colon and potentially death. OBJECTIVE: Present a case of a colonic pseudo-obstruction in a patient with polypharmacy as the only risk factor and to review the medical literature related to the treatment of this pathology...
January 2016: Cirugia y Cirujanos
Carolyn Hanna, John Mullinax, Mark S Friedman, Julian Sanchez
Small bowel diverticulosis is a rare finding within the general population and jejunal diverticulosis, specifically, is even rarer. Clinical manifestations can range from post-prandial pain, constipation and malabsorption to serious complications, such as gastro-intestinal hemorrhage, perforation and acute intestinal obstruction. Here we describe the case of an 81-year-old gentleman who presented with a three-year history of abdominal pain and weight loss. Despite unremarkable physical examination and laboratory tests, persistent pneumoperitoneum and dilated loops of small bowel were found on imaging...
November 2016: Gastroenterology Report
Monique Cebola, Eliza Eddy, Suzanne Davis, Laura Chin-Lenn
Rapid identification of acute colonic pseudo-obstruction (ACPO), or Ogilvie's syndrome, is paramount in the management of this condition, which, if unresolved, can progress to bowel ischemia and perforation with significant morbidity and mortality. We present the first case report, to our knowledge, of ACPO following total laparoscopic hysterectomy. We describe the presentation and management of ACPO in a patient who underwent uncomplicated total laparoscopic hysterectomy to treat menorrhagia and dysmenorrhea after declining conservative treatment...
November 2015: Journal of Minimally Invasive Gynecology
Michael Reeves, Frank Frizelle, Christopher Wakeman, Catherine Parker
BACKGROUND: Acute colonic pseudo-obstruction is an uncommon but potentially morbid complication of pregnancy. The aim of the study was to review a single institution's experience with acute colonic pseudo-obstruction in post-partum patients and develop an algorithm for management based on a literature review. METHODS: This is a retrospective study where patients were identified over a 2-year period (1 December 2012 to 31 November 2014) by checking all deliveries in Christchurch Women's Hospital against diagnosis codes for bowel obstruction and ileus...
October 2015: ANZ Journal of Surgery
Tracy Jaffe, William M Thompson
Large-bowel obstruction is an abdominal emergency with high morbidity and mortality rates if left untreated. Although abdominal radiography is usually the initial imaging study performed in patients suspected of having large-bowel obstruction, it may not be sufficient to distinguish obstruction from other causes of colonic dilatation. Computed tomography is the imaging method of choice as it can establish the diagnosis and cause of large-bowel obstruction. A contrast agent enema may be used to confirm or exclude large-bowel obstruction...
June 2015: Radiology
Maria-Pia Bernardi, Satish Warrier, A Craig Lynch, Alexander G Heriot
Acute colonic pseudo-obstruction (ACPO) and chronic intestinal pseudo-obstruction (CIPO) are distinct clinical entities in which patients present similarly with symptoms of a mechanical obstruction without an occlusive lesion. Unfortunately, they also share the issues related to a delay in diagnosis, including inappropriate management and poor outcomes. Advancements have been made in our understanding of the aetiologies of both conditions. Several predisposing factors linked to critical illness have been implicated in ACPO...
October 2015: ANZ Journal of Surgery
S Müller-Lissner
The motility of the colon is modulated by the enteric nervous system. It is very complex, governing backward and forward movements of the feces. Primary megacolon and megarectum are clinically diverse. Megacolon refractory to laxative treatment may be subject to colectomy, while megarectum should be treated by consistent laxation. Acute colonic pseudo-obstruction may occur with severe systemic diseases and electrolyte disturbances or it may be postoperatively and/or medically induced. A small proportion of chronically constipated patients suffer from slow transit constipation, others from disordered defecation...
June 2015: Der Internist
F Begbie, G Walker, H Kubba, A Sabharwal
Colonic pseudo-obstruction (Ogilvie's Syndrome) in children is relatively uncommon. We report an unusual case of colonic pseudo-obstruction in an 8-year-old child with cerebral palsy and long-term hypomotility issues being treated for drooling with the anticholinergic medication trihexyphenidyl. He presented as an emergency with severe abdominal distension, abdominal tenderness and vomiting. An emergency laparotomy revealed colonic dilatation and a defunctioning ileostomy was created. To our knowledge, this is the first case reporting colonic pseudo-obstruction as a possible complication of treatment with trihexyphenidyl...
June 2015: International Journal of Pediatric Otorhinolaryngology
P Pereira, F Djeudji, P Leduc, F Fanget, X Barth
Ogilvie's syndrome describes an acute colonic pseudo-obstruction (ACPO) consisting of dilatation of part or all of the colon and rectum without intrinsic or extrinsic mechanical obstruction. It often occurs in debilitated patients. Its pathophysiology is still poorly understood. Since computed tomography (CT) often reveals a sharp transition or "cut-off" between dilated and non-dilated bowel, the possibility of organic colonic obstruction must be excluded. If there are no criteria of gravity, initial treatment should be conservative or pharmacologic using neostigmine; decompression of colonic gas is also a favored treatment in the decision tree, especially when cecal dilatation reaches dimensions that are considered at high risk for perforation...
April 2015: Journal of Visceral Surgery
Kerem Karaman, Alpaslan Tanoglu, Yavuz Beyazit, Ismet Han
Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome, is a clinical syndrome characterised by gross dilation of the caecum and right hemicolon, which sometimes extends to the sigmoid colon and rectum in the absence of an anatomic lesion in the intestinal lumen. It is characterised by impaired propulsion of contents of the gastrointestinal tract, which results in a clinical picture of intestinal obstruction. A careful examination of the markedly distended colon can exclude several colonic pathologies, including mechanical obstruction and other causes of toxic megacolon...
2015: BMJ Case Reports
Fares Alahdab, Shreyas Saligram
A 70-year-old woman with end-stage liver disease from hepatitis C was admitted to the hospital for confusion. Portosystemic encephalopathy was diagnosed, and the patient was treated with 20 g of lactulose every 6 hours. A few days after admission, abdominal pain with marked abdominal distention..
January 22, 2015: New England Journal of Medicine
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