Curbside Consultation of the Colon: 49 Clinical Questions

Brooks D. Cash, MD, FACP, CDR, MC, USN

Question 48: The Ward Team Has A Patient With A Distended Abdomen And Increasing Gas-Filled Loops Of Bowel On X-Ray. How Can I Help Them Recognize And Treat Colonic Pseudo-Obstruction (Ogilvie’S Syndrome)? (continued)

Scott L. Itzkowitz, DO, FACP

Acute colonic pseudo-obstruction (Ogilvie’s syndrome) is characterized by dilation of the right colon and cecum not caused by a luminal obstructive lesion. Although Ogilvie’s syndrome was classically described as being related to an underlying retroperitoneal malignancy, today the term is used to describe acute pseudo-obstruction related to any cause. The 3 most common etiologies include trauma, infection, and cardiovascular disease, but patients with systemic illnesses can also develop Ogilvie’s.1 The actual mechanism of the disorder is unknown, but it is believed that…