Ogilvie’s syndrome treated with an emergency laparotomy, right hemicolectomy and end ileostomy

BMJ Case Reports - Trang bcr-2017-220916
Andrew James Robinson1, John-Patrick Quigley2, Athene Banks3, Martin Farmer4
1rew.robinson2{at}uhnm.nhs.uk
2Department of General Surgery, University Hospital of North Staffordshire NHS Trust, Stoke-on-Trent, UK
3Department of General Surgery, Royal Stoke University Hospital, Stoke-On-Trent, UK
4The Royal Stoke University Hospital, Stoke-on-Trent, UK

Tóm tắt

Acute colonic pseudo-obstruction (ACPO), or Ogilvie’s syndrome, is a rare clinical entity in which there is massive non-toxic colonic dilatation in the absence of a mechanically obstructing lesion. It is an important yet poorly recognised cause of surgical morbidity and mortality occurring typically in elderly patients with multiple comorbidities. ACPO can often be reversed conservatively with colonoscopic or nasogastric decompression. Surgical intervention is seldom necessary. We present a case of Ogilvie’s syndrome in which a healthy 76-year-old man developed life-threatening pseudo-obstruction following rib polytrauma after a mechanical fall. Pneumatosis coli was evident radiologically, prompting emergency exploratory laparotomy. Operative findings of serosal tearing and ischaemic colitis necessitated treatment with right hemicolectomy and ileostomy formation. Microbiological and histopathological analyses proved negative for inflammatory, obstructive and infectious colitides. The case emphasises the importance of early recognition and timely intervention in the management of this rare yet potentially fatal cause of megacolon.

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BMJ Case Reports

bcr-2017-220916

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