Colonic Pseudo-Obstruction: Ogilvie’s Syndrome

Abstract

Acute colonic pseudo-obstruction (Ogilvie’s syndrome) is a rare disorder associated with spontaneous colonic dilatation with signs and symptoms of mechanical bowel obstruction and dilatation on imaging. We report a 37 year-old female, with three-month history of Caesarian Section at 38th week of pregnancy due to fetal malpresentation. Abdominal CT-scan revealed chronic diffuse colonic distention, 17 cm in diameter. No cause of obstruction could be determined. A diagnosis of Ogilvie’s syndrome was made. The increased size of the colon with leukocytosis warranted urgent colonoscopic decompression. The patient recovered well. If not managed appropriately, Ogilvie’s syndrome can progress to bowel ischemia and perforation with significant morbidity and mortality. The first line of treatment of early disease is conservative management with neostigmine or colonoscopic decompression. Our purpose is to review the diagnosis and management of this potentially lethal rare condition.