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2017, Number 2

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Rev Med MD 2017; 8.9 (2)

Ogilvie syndrome

Morfín-Plascencia LM

Language: Spanish
References: 20
Page: 170-176
PDF size: 762.62 Kb.


ABSTRACT

Ogilvie syndrome (OS) or acute pseudo-obstruction of the colon is characterized by a massive and acute dilation of the colon, especially on the right side. It is a rare entity, predominantly affects the male gender, and occurs in hospitalized patients with some serious medical or surgical condition. In its pathophysiology, an imbalance in the autonomic nervous system is suspected, although it is still not entirely clear. It presents with moderate to severe abdominal distension, colic pain in the hypogastrium and constipation. Sepsis, necrosis or intestinal perforation should be suspected if fever develops. The diagnosis is suggested by the clinical presentation and is confirmed by abdominal radiographs which can show different degrees of colonic dilatation, mainly in the right colon. The presence of pneumoperitoneum confirms the presence of an intestinal perforation. Computed tomography is a more detailed imaging resource for diagnosis. A cecal diameter of ‹12 cm allows a conservative treatment, however if it is› 12 cm it indicates that a surgical intervention must be performed due to the imminent risk of perforation. Among the therapeutic options are the use of neostigmine, erythromycin, cisapride, colonoscopy with decompression, cecostomy and surgery.


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