Acute Colonic Pseudo-obstruction: Defining the Epidemiology, Treatment, and Adverse Outcomes of Ogilvie's Syndrome

Ross, Samuel W.; Oommen, Bindhu; Wormer, Blair A.; Walters, Amanda L.; Augenstein, Vedra A.; Heniford, B. Todd; Sing, Ronald F.; Christmas, A. Britton

doi:10.1177/000313481608200211

Cited by 69 publications

(79 citation statements)

References 23 publications

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“…The term “intestinal pseudo-obstruction” was first proposed by Dudley in 1958[ 11 ], with “ACPO” not appearing for another twenty years[ 4 ]. Use of “Ogilvie’s syndrome” has been discouraged due to ambiguity regarding its meaning[ 12 ], though considerable heterogeneity in terminology still exists in recent literature[ 3 , 13 , 14 ].…”

Section: Resultsmentioning

confidence: 99%

“…ACPO usually occurs in hospitalised patients with severe illness or trauma, or following general, orthopaedic, neurosurgical, gynaecological or other surgical procedures, with an estimated incidence of 100 cases per 100000 admissions and a mortality rate of 8%[ 2 , 3 ]. Colonic ischaemia or perforation occurs in up to 15%, and is associated with an estimated 40% mortality[ 4 - 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Acute colonic pseudo-obstruction: A systematic review of aetiology and mechanisms

Wells

O’Grady

Bissett

2017

WJG

119

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AIMTo critically review the literature addressing the definition, epidemiology, aetiology and pathophysiology of acute colonic pseudo-obstruction (ACPO).METHODSA systematic search was performed to identify articles investigating the aetiology and pathophysiology of ACPO. A narrative synthesis of the evidence was undertaken.RESULTSNo consistent approach to the definition or reporting of ACPO has been developed, which has led to overlapping investigation with other conditions. A vast array of risk factors has been identified, supporting a multifactorial aetiology. The pathophysiological mechanisms remain unclear, but are likely related to altered autonomic regulation of colonic motility, in the setting of other predisposing factors.CONCLUSIONFuture research should aim to establish a clear and consistent definition of ACPO, and elucidate the pathophysiological mechanisms leading to altered colonic function. An improved understanding of the aetiology of ACPO may facilitate the development of targeted strategies for its prevention and treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute colonic pseudo-obstruction: A systematic review of aetiology and mechanisms

Wells

O’Grady

Bissett

2017

WJG

119

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“…Ogilvie's syndrome describes an acute colonic pseudo-obstruction responsible for dilatation of part or all of the colon and rectum without intrinsic or extrinsic mechanical obstruction, on a previously healthy colon [1]. The main complication is the perforation, cecal diameter upper to 12 cm (on plain supine radiographs) is considered worrisome for perforation.…”

Section: Discussionmentioning

confidence: 99%

Ogilvie Syndrome Associated to Parkinson’s Disease

Echchikhi¹,

Essaber²,

Sekkat³

et al. 2019

OJCD

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Ogilvie's syndrome is an acute dilatation of a part or all of the colon and rectum without mechanical obstruction. The diagnosis is based on computed tomography (CT) that excludes organic or functional colonic obstruction and ensures the detection of signs of severity. Rapid diagnosis leads to conservative measures and the resolution of obstruction. Delays in diagnosis can lead to complications imposing a surgical treatment and increased mortality rate. We report the case of a 52 years old woman with Parkinson's disease, who presented Ogilvie's syndrome. The initial assessment did not show signs of severity, so medical treatment was introduced but without improvement; for this reason, the surgical procedure was indicated as a cecostomy. There are several theories that explain the pathophysiology of Ogilvie's syndrome; the most likely is the dysfunction of innervation of the colon which is due to Parkinson's disease in our case. The diagnosis is based on computed tomography. The treatment is pharmacologic, conservative or surgical depending on the severity of the disease and its evolution.

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“…Gesichert wirksam ist die intravenöse Gabe von Neostigmin [6] mit Erfolgsraten von 89 % in einer Metaanalyse [38]. Auch in der weltweit bisher größten Studie mit über 106 000 Fällen konnten 90,5 % konservativ therapiert werden, nur bei 2,7 % war eine endoskopische und bei 6,3 % eine chirurgische Intervention sowie bei 0,5 % die Kombination aus beiden erforderlich [39].…”

Section: Dekompression Bei Erkrankungen Ohne Stenoseunclassified

“…PEC) erreicht werden, dann ist allerdings die Komplikationsrate mit Peritonitis deutlich höher als bei der transanalen Dekompression. In medikamentös und endoskopisch therapierefraktären Fällen hat die Operation eine deutlich höhere Letalität [39].…”

Section: Dekompression Bei Erkrankungen Ohne Stenoseunclassified

Positionspapier der DGVS zur endoskopischen Dekompression bei akutem Ileus

et al. 2017

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In patients with ileus with dilated intestine in imaging studies, endoscopic decompression appears a feasible option. However, its use is often uncritical and without scientific evidence. Before considering endoscopic intervention, CT-imaging should differentiate between mechanical obstruction and paralytic ileus/intestinal pseudo-obstruction. Tumor diagnosis and localisation are essential because the latter determines the choice of the decompression procedure. Coecal dilatation of more than 12 cm indicates an increased risk of perforation. In patients with toxic megacolon, dilation of the transverse colon to more than 6 cm is considered critical without much prospective evidence. Endoscopic decompression has a high complication rate and should be performed electively, and not as an emergency procedure, whenever possible. The use of CO insufflation rather than ambient air is strongly recommended, as is the availability of fluoroscopy. Prior trans-nasal or oral decompression-tube placement is routinely performed, and tracheobronchial intubation frequently required. In over 90 % of patients with pseudo-obstruction, conservative treatment is successful within 24 to 48 hours, and endoscopic decompression is, therefore, unnecessary. Placement of self-expanding metal stents to decompress a tumor stenosis is considered mostly for the left colon and rectum and burdened with significant risks of perforation and stent migration. Stent impact on oncological outcome is controversial because of possible tumor cell mobilization and increased postoperative cancer recurrence rates. Surgery, as primary intervention, achieves its objective in most cases. Decompression effect by endoscopic suctioning of gas and intestinal fluid is usually transient so that it is combined with transrectal decompression tubes insertion. This paper reviews the advantages and flaws of various decompression procedures in different clinical settings.

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Acute Colonic Pseudo-obstruction: Defining the Epidemiology, Treatment, and Adverse Outcomes of Ogilvie's Syndrome

Cited by 69 publications

References 23 publications

Acute colonic pseudo-obstruction: A systematic review of aetiology and mechanisms

Acute colonic pseudo-obstruction: A systematic review of aetiology and mechanisms

Ogilvie Syndrome Associated to Parkinson’s Disease

Positionspapier der DGVS zur endoskopischen Dekompression bei akutem Ileus

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