A Rare Cause of Acute Colonic Pseudo-obstruction: Ogilvie's Syndrome Caused by Herpes Zoster

Chung, Jae Yoon; Park, Jong Seol; Kim, Yong Sung

doi:10.5056/jnm17078

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…Many conditions are associated with ACPO. Common risk factors for severe complications or infections, including critical illness, recent hand surgery, metabolic imbalance, and other non-surgical causes [ 3 , 6 , 8 ], in elderly patients and inpatients, are widely reported [ 5 , 9 , 10 ]. In women, the most common causes are C-section and pregnancy, followed by pelvic surgery and trauma [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Acute colonic pseudo-obstruction with bowel rupture after caesarean section in HELLP syndrome: a case report

Peng

Cheng

2020

BMC Pregnancy Childbirth

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Background Ogilvie syndrome, also known as acute colonic pseudo-obstruction (ACPO), can occur postpartum after caesarean section (C-section), often resulting in caecal dilatation. The incidence rate is approximately 100 cases in 100,000 patients per year (Ross et al., Am Surg 82:102-11, 2016). Without proper diagnosis and treatment, it may progress to intestinal perforation or other fatal complications. Case presentation A 39-year-old pregnant woman underwent emergency low-segment C-section due to complications of Haemolysis, Elevated Liver enzymes and Low Platelets syndrome (HELLP) syndrome. ACPO was suspected on the third day after C-section based on inability to pass flatus, evident abdominal distension, slight abdominal pain, and computed tomography (CT) scan revealing severe, diffuse colonic distention with caecal dilatation of approximately 9 cm. Based on these findings, conservative treatment was implemented. However, 6 days after C-section, her symptoms worsened, and CT showed possible intestinal perforation; thus, an emergency laparotomy was performed. Due to a 3-cm (diameter) laceration in the anterolateral wall of the ascending colon and a 5-cm tear in the ileocecal junction, in combination with mucosal eversion in the colon, resection of the ileocecum, distal closure of the ascending colon, and a terminal ileostomy were performed. The patient was discharged 2 weeks post-laparotomy and continued to undergo nursing care for the incision and stoma. Ileostomy was performed 4 months later. Conclusion Ogilvie syndrome after C-section is an extremely rare but severe condition, which warrants early recognition and treatment to prevent potentially fatal complications, especially in patients with poor health status.

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Section: Discussionmentioning

confidence: 99%

Acute colonic pseudo-obstruction with bowel rupture after caesarean section in HELLP syndrome: a case report

Peng

Cheng

2020

BMC Pregnancy Childbirth

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“…Several studies have reported an etiopathogenic association between Herpes Zoster and Ogilvie Syndrome in the absence or presence of HIV/AIDS due to the simultaneous occurrence of herpetiform rash and pseudo-obstruction as well as the rapid resolution of the abdominal dilation and the functional recovery from the colonic pseudo-obstruction after antiviral therapy. There also has been the demonstration of varicella-zoster virus infection by immunohistochemistry and viral particles in the muscularis propria and myenteric plexi of the colon in an HIV-positive patient with herpes zoster and Ogilvie's syndrome [ 16 - 20 ]. The incident patient was a middle-aged female who was well-nourished and not hospitalized or institutionalized without any acute severe medical or surgical illness.…”

Section: Discussionmentioning

confidence: 99%

Ogilvie syndrome: peculiar manifestation of acquired immunodeficiency syndrome (AIDS) in non-institutionalized middle age female in Tanzania

Jusabani¹,

Jusabani²,

Patel³

et al. 2020

Pan Afr Med J

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Since it was first documented in 1948 by Sir William Heneage Ogilvie, numerous cases of Ogilvie syndrome have been described in literature due to various medical and surgical causes. Nonetheless, only a handful of cases only have been documented due to underlying Acquired Immunodeficiency Syndrome (AIDS). A 41-year-old female was admitted with an acute abdomen secondary to partial mechanical intestinal obstruction or paralytic ileus based on signs and symptoms and Abdominal X-Ray (AXR). She was known to be HIV/AIDS WHO clinical stage II on treatment. On diagnostic imaging studies she had distended large bowels without features of mechanical intestinal obstruction and the diagnosis of Ogilvie syndrome was suspected after other differentials were excluded. Early recognition and appropriate management are essential, because if left untreated the bowel distension may progress to caecal perforation and fatal peritonitis. Medical imaging with Computer Tomography (CT) scan and colonoscopy has helped in achieving an accurate diagnosis and avoiding unnecessary laparotomies. Although an uncommon disorder, for earlier and accurate diagnosis a high index of suspicion is required by clinicians and radiologists who are treating patients with underlying HIV/AIDS. Ogilvie’s syndrome is a rare condition and if missed can be fatal. In patients with HIV/AIDS, the symptoms may be directly due to HIV infection, secondary to opportunistic infections or possible neurotoxic effects of HIV treatment or lack of vitamin and minerals. It is important to exclude Ogilvie syndrome in patients from surgical causes of the acute abdomen to avoid unnecessary surgical procedures.

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“…This condition may lead to cecal perforation but sometimes spontaneous recovery was reported. It may accompany situations such as herpes zoster infection in lymphomas [17], old age, bedridden patients, obese patients, in chronic constipation, in patients with blunt trauma, burns, hip replacement, after Caesarian section, choriocarcinoma etc. The colonic dilatation, which is accompanied by intermittent flatus change and lack of bowel sounds, is relieved by colonoscopic decompression, water soluble contrast administered orally or rectally, naso-gastric aspiration, enema, neostigmine, or operation.…”

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confidence: 99%

Wilkie or Ogilvie?

Ohry

2018

Spinal Cord Ser Cases

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A Rare Cause of Acute Colonic Pseudo-obstruction: Ogilvie's Syndrome Caused by Herpes Zoster

Cited by 8 publications

References 7 publications

Acute colonic pseudo-obstruction with bowel rupture after caesarean section in HELLP syndrome: a case report

Acute colonic pseudo-obstruction with bowel rupture after caesarean section in HELLP syndrome: a case report

Ogilvie syndrome: peculiar manifestation of acquired immunodeficiency syndrome (AIDS) in non-institutionalized middle age female in Tanzania

Wilkie or Ogilvie?

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