What is Ogilvie syndrome?
Colonic pseudoobstruction presents with signs, symptoms, and radiologic findings suggestive of obstruction without a mechanical source.
It is most often seen in hospitalized patients with other underlying medical conditions found to have marked colonic air on abdominal radiograph.
How is Ogilvie syndrome treated?
The vast majority of patients improve with bowel rest and removal of narcotics; however, colonic decompression is indicated in the presence of pain or significant distention (more than 12 cm). Intravenous neostigmine as a prokinetic agent has a high success rate (greater than 80%–90% in some small series), although cardiac risk must be assessed prior to administration. Tube cecostomy can be considered in moribund patients.
Treatments include managing the underlying medical issues, colonoscopic decompression, and neostigmine.