Ogilvie′s syndrome in a case of myxedema coma (original) (raw)
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Acute colonic pseudo-obstruction in vascular patients (Ogilvie syndrome)
Acta chirurgica Belgica
Two patients with acute colonic pseudo-obstruction are presented. Acute colonic pseudo-obstruction, first described by Ogilvie in 1948, is characterised by signs of colonic obstruction, but without mechanical obstruction to the intestinal flow. The current hypothesis states that it is caused by an imbalance between sacral parasympathetic excitatory nerves and sympathetic inhibitory nerves, thus inducing functional obstruction. It mostly develops in hospitalised patients with a variety of medical and surgical conditions. Two such patients with extensive co-morbidities, developed progressive colon dilatation with signs of acute peritonitis, and were operated on urgently. In both patients, right hemicolectomy and postoperative medical treatment resulted in complete recovery.
A rare cause of ileus: Ogilvie syndrome
Istanbul Bilim University Florence Nightingale Journal of Medicine, 2017
Background: Acute colonic pseudo-obstruction/Ogilvie syndrome presents as massive colonic dilatation without a identifiable cause. Hypothyroidism is a rare cause of colonic pseudo-obstruction. Here we present a case of Ogilvie Syndrome in a previously undiagnosed hypothyroid patient. Case Report: A 45 year old female presented with features of intestinal obstruction clinically and radiologically. She underwent laparotomy and there were no features of mechanical obstruction. On retrospective analysis of her thyroid profile, she was found to be hypothyroid and was frankly started on thyroid supplementation. Bowel motility was regained subsequently. A retrospective analysis of literature for hypothyroidism as a cause for colonic pseudo-obstruction was done and here we present the case report Conclusion: Hypothyroidism is a rare cause of intestinal obstruction which can be easily reversed with thyroid supplementation and should be considered in every case of suspected non-mechanical intestinal obstruction
O'Gilvie's Syndrome (colonic pseudo-obstruction) in the intensive care unit
Critical Care, 1998
Background: Whole body hyperthermia induced by radiative systems has been used in therapy of malignant diseases for more than ten years. Von Ardenne and co-workers have developed the 'systemiche Krebs-Mehrschritt-Therapic' (sKMT), a combined regime including whole body hyperthermia of 42°C, induced hyperglycaemia and relative hyperoxaemia with additional application of chemotherapy. This concept has been employed in a phase I/II clinical study for patients with metastatic colorectal carcinoma at the Virchow-Klinikum since January 1997. Methods: The sKMT concept was performed eleven times under intravenous general anaesthesia, avoiding volatile anaesthetics. Core temperatures of up to 42°C were reached stepwise by warming with infrared-A-radiation (IRATHERM 2000®). During the whole procedure blood glucose levels of 380-450 mg/dl were maintained as well as PaO 2 levels above 200 mmHg. Extensive invasive monitoring was performed in all patients including measurements with the REF-Ox-Pulmonary artery catheter with continuous measuring of mixed venous saturation (Baxter Explorer®) and invasive monitoring of arterial blood pressure. Data for calculation of hemodynamic and gas exchange parameters were collected four times, at temperatures of 37°C, 40°C, 41.8-42°C and 39°C, during measurements FiO 2 was 1.0 at all times. Fluids were given in order to keep central-venous and Wedge pressure within normal range during the whole procedure. Statistics were performed using the Wilcoxon Test. Results: Statistically significant differences were found between heart rate, cardiac index and systemic vascular resistance comparing data at 37°C and 42°C. Heart rate and cardiac index increased to a maximum at 42°C (P < 0.0001) whereas systemic vascular resistance had its minimum at 42°C (P < 0.0001). Mean arterial pressure dropped with increasing temperature, differences were not significant. Calculation of stroke volume index and ventricular volumes showed only a slight decrease in endsystolic volumes with increasing temperature, the resulting differences in right ventricular ejection fraction were marginally significant (P = 0.038) comparing 42°C to baseline. Right ventricular stroke work index as well as mean pulmonary arterial pressure increased at 42°C (P = 0.0115 and P = 0.0037), pulmonary vascular resistance only dropped little compared to systemic vascular resistance, left ventricular stroke work index even dropped with increasing temperature, though showing no significant difference. Values for mixed venous oxygen saturation did not vary during therapy, pulmonary right-left shunt showed a temperature associated increase (P = 0.0323) to a maximum at 42°C. Conclusion: Under the procedure of sKMT cardiac function in patients, who do not have any pre-existing cardiac impairment, can be maintained almost unchanged, ie with normal right and left ventricular pressure, despite an increase in right ventricular stroke work Acknowledegment: Supported by Deutsche Krebshilfe.
Chirurgia
Pseudo-obstrucţia intestinală acută sau sindromul Ogilvie reprezintă o entitate patologică cu potenţial letal, secundară dilataţiei masive colonice, în absenţa unei cauze obstructive mecanice. Apare, de obicei, în rândul pacienţilor spitalizaţi sau instituţionalizaţi ce prezintă comorbidităţi severe medicale sau chirurgicale. Fiziopatologia pseudo-obstrucţiei intestinale acute nu este pe deplin cunoscută, însă, se presupune faptul că un dezechilibru al reglării autonome a funcţiei motorii colonice ar constitui principala cauză. Diagnosticul precoce şi instituirea rapidă a managementului terapeutic optim reprezintă principalele elemente ce scad riscul apariţiei complicaţiilor severe de tipul ischemiei sau perforaţiei colonice. Pe lângă experienţa noastră, a fost elaborat un studiu al literaturii recente de specialitate în scopul evaluării incidenţei, etiologiei, tabloului clinic şi diagnosticului pseudoobstrucţiei intestinale acute. Scopul prezentului studiu este de a stabili algoritmul terapeutic optim pentru pacienţii critici cu risc înalt de
Ogilvie syndrome presenting with septic shock
The Turkish Journal of Pediatrics, 2018
Acute colonic pseudo-obstruction (ACPO) is also known as Ogilvie's. We report a 10-year-old child with an unremarkable past history who presented with septic shock including hypotension, prolonged capillary refill time, decreased urine output (<0.5 ml/kg/h), metabolic acidosis, liver failure, respiratory failure. The symptoms resolved with supportive therapy. In our patient septic shock contributed to Ogilvie syndrome. Although it is a rare condition in pediatric population, pediatricians should be aware of children with abdominal distention; supportive management is successful and morbidity/ mortality is minimal.
Acute Intestinal Pseudo-Obstruction (Ogilvie's Syndrome)
Clinics in colon and rectal surgery, 2005
Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome, is a condition characterized by massive colonic distension in the absence of mechanical obstruction. Patients presenting with Ogilvie's syndrome have underlying medical and ...
Case Report on Ogilvie Syndrome in a Non-Surgical Candidate
Archives of Medical Case Reports
Ogilvie syndrome, also known as “paralytic ileus of the colon,” is characterized by pseudo- obstruction of the colon without any component of mechanical obstruction; and presents as a massively distended abdomen. If left untreated, it carries a high risk of colonic perforation and ischemia leading to death. Ogilvie syndrome usually presents as a post-surgical complication, mainly due to the lack and/or restriction of movement coupled with a possible electrolyte imbalance. In this case, the patient was a non-surgical candidate who presented with a hip fracture after a mechanical fall. Three days post-fall, she developed nausea, abdominal discomfort, and constipation during her hospitalization, which gradually resulted in a massively distended abdomen. The patient was managed conservatively with a nasogastric tube, rectal tube decompression, Metoclopramide, and Magnesium Citrate administration. Abdominal X-rays showed massively dilated bowel loops. An abdominal CT scan showed diffuse ...
Ogilvie's syndrome in the postcesarean section patient
International Journal of Gynecology & Obstetrics, 1989
Two cases of colonic pseudo-obstruction (the so-called Ogilvie's syndrome) are reported. Both patients were in the immediate postcesarean section puerperium. The importance of early diagnosis in these cases is stressed, because this complication has a high mortality rate, frequently in relation to delayed diagnosis and treatment. One patient was successfully treated with conservative measures because diagnosis was made early. A plain X-ray abdominal film which shows cecum dilatation, with or without ascending and transverse colon dilatation, and no distal air, makes the diagnosis. A cecum diameter of 9 cm or more is a surgical indication, because the possibility of wall perforation is high. Surgical techniques are: puncture decompression or cecostomy. When cecum diameter is less than 9 cm, non-surgical measures (nasogastric suction, correction of any fluid and electrolytic imbalance, and maybe a flatus tube) are indicated. Observation through repeated X-ray abdominal films shows when the surgical indication appears: (I) failure of the conservative treatment (cecal distension continues or increases); or (2) cecal perforation is documented.