Ogilvie's Syndrome in the Surgical Patient: A New Therapeutic Modality

Carol R. Schermer, James J. Hanosh, Michael Davis, David E. Pitcher

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Acute colonic pseudo-obstruction, Ogilvie's syndrome, most often appears as a complication of other clinical conditions. It is characterized by massive colonic dilation in the absence of a mechanical cause. Therapy for this condition has traditionally been colonoscopic decompression via a flexible colonoscope. We performed a retrospective study to assess the efficacy of Cystografin enema for colonic decompression in Ogilvie's syndrome. We present a series of 18 patients who developed Ogilvie's syndrome while hospitalized for trauma (n = 10), burn (n = 1), gastrointestinal surgery (n = 4), and hip replacement (n = 3). The mean pre-enema cecal size was 13 cm (range 10 to 15 cm). The mean postenema cecal size was 8.5 cm (range 6 to 15 cm). Fifteen of the 18 patients underwent Cystografin enema as the primary mode of decompression. Three had undergone prior colonoscopy, which had failed. One of the 18 patients required repeat enema for inadequate decompression after the first enema and one underwent colonoscopy for recurrence. Two patients underwent operative intervention after the enema. There were no complications related to the enema. In all patients we were able to rule out a mechanical cause of large bowel obstruction. We believe the safety, efficacy, and ease of this procedure make Gystografin enema optimal first-line treatment for acute colonic pseudo-obstruction.

Original languageEnglish (US)
Pages (from-to)173-177
Number of pages5
JournalJournal of Gastrointestinal Surgery
Volume3
Issue number2
StatePublished - Mar 1999
Externally publishedYes

Keywords

  • Colonic pseudo-obstruction
  • Ogilvie's syndrome
  • Therapeutic enema

ASJC Scopus subject areas

  • Surgery

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    Schermer, C. R., Hanosh, J. J., Davis, M., & Pitcher, D. E. (1999). Ogilvie's Syndrome in the Surgical Patient: A New Therapeutic Modality. Journal of Gastrointestinal Surgery, 3(2), 173-177.