Ogilvie's syndrome after an emergency caesarean section: A case report

Bhakta, Ankita; Li, Tingmin; Bhagwanani, G.; Rao, Tanushree

doi:10.1016/j.crwh.2022.e00392

Cited by 2 publications

(3 citation statements)

References 10 publications

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“…However, a transition point may present gradually at or near the splenic flexure [ 14 ]. CT imaging usually provides an accurate measurement of the degree of bowel dilation in order to direct the decision for the needed intervention [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Mortality Due to Complications Associated With Acute Ogilvie’s Syndrome in an Older Adult Treated for Psychosis: A Case Report

Ali,

Al Saeed,

Ebrahim

et al. 2023

Cureus

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Acute colonic pseudo-obstruction or Ogilvie's syndrome is a disorder causing massive colonic dilation with no evidence of mechanical obstruction. The actual incidence of acute colonic pseudo-obstruction is unclear; However, electrolyte imbalance, psychiatric disorders, the use of medications such as anticholinergics or antipsychotics, and recent abdominal surgery are the most common predisposing factors associated with this syndrome. Ogilvie's syndrome is most likely caused due to impairment of the gut's motor system and an imbalance of the autonomic nervous system including a reduction in the activity of stimulatory neurotransmitters. The predisposition to psychotic disorders could be, in some instances, due to neurodevelopmental abnormalities of the brain and the gut’s autonomic nervous system. The symptoms of Ogilvie's syndrome are similar to mechanical obstruction of the colon but no physical cause of obstruction is usually present. Ogilvie's syndrome can be managed conservatively; however, if left untreated, Ogilvie's syndrome can lead to bowel perforation, which is associated with a high mortality risk. Antipsychotics have been considered the cornerstone treatment for psychiatric disorders including schizophrenia. Even though they are highly effective in treating psychiatric illnesses, their usage carries multiple risks. Overall, constipation is a common side effect of antipsychotic medications with some classes posing more risk than others. Constipation can be severe and may lead to serious complications such as paralytic ileus, bowel ischemia, and death. We present here a case of delusional disorder managed with risperidone and complicated by intestinal pseudo-obstruction. This case reiterates the need to consider all complications of antipsychotic medications, even rare ones, and include them in the discussion with patients and their caregivers before commencement.

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Section: Discussionmentioning

confidence: 99%

Mortality Due to Complications Associated With Acute Ogilvie’s Syndrome in an Older Adult Treated for Psychosis: A Case Report

Ali,

Al Saeed,

Ebrahim

et al. 2023

Cureus

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“…Only 10% ( n = 2) of patients were successfully managed conservatively, 20% ( n = 4) were managed with endoscopic decompression, and the remaining 70% ( n = 14) required operative intervention. The majority of the 14 patients ( n = 10) were found to have evidence of ischemia or perforation at the time of laparotomy 7–19 …”

Section: Literature Reviewmentioning

confidence: 99%

“…found to have evidence of ischemia or perforation at the time of laparotomy. [7][8][9][10][11][12][13][14][15][16][17][18][19] On further review of the references from these studies, we identified a systematic review of case reports and case series pertaining to postpartum ACPO that were reported after 2002. The study identified 66 cases reported through 37 publications; 62 cases occurred after cesarean section.…”

Section: Casementioning

confidence: 99%

Acute colonic pseudo‐obstruction post‐cesarean section is not a benign entity: A case series and review of the literature

Reynolds,

McDermott,

Liddy

et al. 2023

Intl J Gynecology & Obste

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Acute colonic pseudo‐obstruction (ACPO) is an infrequent occurrence after cesarean section. Anecdotal evidence suggests that the clinical course of ACPO in the obstetric setting is different to that seen in non‐pregnant adult patients with ACPO secondary to alternative causes, such as systemic illnesses, the use of certain medications, and after non‐abdominal surgery. The risk of progression to ischemia and perforation, as well as the need for emergency surgery, appears to be higher after cesarean section. Here we describe the clinical course of ACPO in four patients after cesarean section from our institution, followed by a review of the literature and a discussion of the important issues surrounding this condition in the postpartum time period. The findings from our cohort of patients and the reports from the medical literature support a hands‐on combined approach from a group of specialists including obstetricians, surgeons, radiologists, and enterostomal therapists. Immediate imaging followed by regular observation is mandatory for any patient being managed conservatively. Early use of endoscopic decompression should be considered for patients who are not resolving with a conservative approach. Clinical signs of peritonism or radiological signs of ischemia or perforation in patients with ACPO mandate immediate surgical intervention. Appropriate postoperative care is necessary to deal with the complex physiological and psychological consequences of emergency surgery and potential stoma formation so soon after cesarean section.

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Ogilvie's syndrome after an emergency caesarean section: A case report

Cited by 2 publications

References 10 publications

Mortality Due to Complications Associated With Acute Ogilvie’s Syndrome in an Older Adult Treated for Psychosis: A Case Report

Mortality Due to Complications Associated With Acute Ogilvie’s Syndrome in an Older Adult Treated for Psychosis: A Case Report

Acute colonic pseudo‐obstruction post‐cesarean section is not a benign entity: A case series and review of the literature

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