Pseudo-obstruction of the colon, first described by Ogilvie1 in 1948 and usually referred to as Ogilvie's syndrome, is a specific variety of adynamic ileus. It is characterized by massive colonic dilatation with a clinical and radiologic findings very similar to mechanical large intestinal obstruction, except that there is no organic obstruction. The cecum is usually the site of greatest dilatation, though the whole large bowel may be involved, from the terminal ileum up to the rectosigmoid junction. The dilatation is rapidly progressive and, if untreated, may even cause cecal necrosis and perforation, with highly increased mortality rate. The syndrome has been associated with various metabolic and organic dysfunctions, and has been observed following gynecologic as well as simple surgical procedures; yet its occurrence has been rather uncommon. The followings are two case reports with this syndrome.
Cecum ; Colon* ; Colonic Pseudo-Obstruction* ; Dilatation ; Ileum ; Ileus ; Intestinal Obstruction ; Mortality ; Necrosis

A clinical study was made on urinary diversion following 28 cases of total cystectomy who had been admitted to the Department of Urology, Chonbuk National University, Medical School from March 1980 to June 1986. The results were as follows : 1. The age and sex distribution were from 27 to 70 years, most common in fifth decade and 23 cases were male, 5 cases were female. 2. The underlying diseases for total cystectomy were bladder tumor in 21 cases, prostatic tumor in 2 cases, urethral tumor in 1, left lower ureter and bladder tumor in 2, multiple bladder, left lower ureter and banal pelvis tumor in 1 and vesico-vagino-rectal fistula with myoma uteri in 1 case. 3. The types of urinary diversion were cutaneous ureterostomy in 1 case, ileal conduit in 9, sigmoid conduit in 2, ileocecal conduit in 4, Kock continent ileal reservoir in 1, modified Kock continent ileal reservoir in 7, ureterosigmoidostomy in 4 cases. 4. In renal function, 75 percent of cases were maintained or improved postoperatively. In excretory urographic findings, 71 percent of cases were maintained and 29 percent of cases were deteriorated postoperatively. 5. Early complications were wound infection in 2 cases, wound dehiscence in 2, paralytic ileus in 1, mechanical ileus in 1, enterocutaneous fistula in 1 and leak at ureteroileal anastomosis in 1 cases. 6. Late complications were leak at ureteroileal anastomosis in 1 case and stomal herniation in 1 case.
Colon, Sigmoid ; Colonic Pouches ; Cystectomy* ; Female ; Fistula ; Humans ; Ileus ; Intestinal Fistula ; Intestinal Pseudo-Obstruction ; Jeollabuk-do ; Male ; Myoma ; Pelvis ; Schools, Medical ; Sex Distribution ; Ureter ; Ureterostomy ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Diversion* ; Urology ; Uterus ; Wound Infection ; Wounds and Injuries

Pseudo-obstruction is a clinical syndrome caused by ineffective intestinal propulsion and characterized by symptoms and signs of intestinal obstruction in the absence of an occluding lesion of the intestinal lumen. A 65-year-old male who complained of abdominal pain and obspitation. (not constipation?) was admitted. Simple abdominal radiographs revealed marked colonic dilatation without mechanical obstruction suggesting pseudo-obstruction. Clinical response with conservative care failed to improve the patient. 2.0 mg of neostigmine which was recently reported to be an effective way to decompress the colon in patients with acute colonic pseudo-obstruction, was administered. Immediate clinical response was achieved without complication.
Abdominal Pain ; Aged ; Colon ; Colonic Pseudo-Obstruction ; Dilatation ; Humans ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction ; Male ; Neostigmine*

Pseudo-obstruction is a clinical syndrome caused by ineffective intestinal propulsion and characterized by symptoms and signs of intestinal obstruction in the absence of an occluding lesion of the intestinal lumen. A 65-year-old male who complained of abdominal pain and obspitation. (not constipation?) was admitted. Simple abdominal radiographs revealed marked colonic dilatation without mechanical obstruction suggesting pseudo-obstruction. Clinical response with conservative care failed to improve the patient. 2.0 mg of neostigmine which was recently reported to be an effective way to decompress the colon in patients with acute colonic pseudo-obstruction, was administered. Immediate clinical response was achieved without complication.
Abdominal Pain ; Aged ; Colon ; Colonic Pseudo-Obstruction ; Dilatation ; Humans ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction ; Male ; Neostigmine*

Acute colonic pseudo-obstruction (Ogilvie syndrome) associated with herpes zoster is extremely rare, and few cases have been reported. An 81-year-old woman diagnosed with herpes zoster was referred for accompanying colonic ileus. The diameter of the cecum was 7 cm and a computed tomographic scan showed no definite obstructive cause. Because the patient showed minimal improvement with conservative treatment, endoscopic colonic decompression was performed successfully. Previous studies revealed that the treatment of Ogilvie syndrome associated with herpes zoster does not differ from that of other conditions, and the role of the varicella-zoster virus in this syndrome is unclear. Here, we present the first case of Ogilvie syndrome associated with herpes zoster in Korea, which was improved by endoscopic colonic decompression.
Aged, 80 and over ; Cecum ; Colon ; Colonic Pseudo-Obstruction ; Decompression ; Female ; Herpes Zoster ; Herpesvirus 3, Human ; Humans ; Ileus ; Korea

A chronic intestinal pseudo-obstruction is a rare disorder and a severe digestive syndrome. It is characterized by deranged gut propulsive motility that resembles a mechanical obstruction, but no obstructive process is present. An intestinal pseudo-obstruction may be classified as acute or chronic; the chronic form may also be classified as idiopathic or secondary to a variety of diseases. Treatment of intestinal pseudo-obstruction involves nutritional, pharmacological, and surgical therapies. Surgery should be limited to patients who are refractory to medical therapy and show a deteriorating course. Despite available medical and surgical interventions, the outcome remains poor. Here, we describe a case of a 54-year-old female with chronic constipation and abdominal distension, who was subsequently found to have segmental aganglionosis. The patient was treated with a subtotal colectomy and ileosigmoidostomy without sequelae.
Adult ; Colectomy ; Colonic Pseudo-Obstruction ; Constipation ; Female ; Fluconazole ; Hirschsprung Disease ; Humans ; Intestinal Pseudo-Obstruction ; Middle Aged

Ketamine is a rapidly acting dissociative anesthetic that can be administered as a sole agent, an induction agent, or a supplement to low potency anesthetic agents.It is usually used for the minor surgery or outpatient surgery in pediatric anesthesia because of the undesirable psychotomimetic side effects of ketamine are less common in the children. We report that a pediatric patient had experienced a profound paralytic ileus after ventilation tube insertion with ketamine anesthesia.
Ambulatory Surgical Procedures ; Anesthesia ; Child ; Humans ; Ileus ; Intestinal Pseudo-Obstruction ; Ketamine ; Surgical Procedures, Minor ; Ventilation

Ketamine is a rapidly acting dissociative anesthetic that can be administered as a sole agent, an induction agent, or a supplement to low potency anesthetic agents.It is usually used for the minor surgery or outpatient surgery in pediatric anesthesia because of the undesirable psychotomimetic side effects of ketamine are less common in the children. We report that a pediatric patient had experienced a profound paralytic ileus after ventilation tube insertion with ketamine anesthesia.
Ambulatory Surgical Procedures ; Anesthesia ; Child ; Humans ; Ileus ; Intestinal Pseudo-Obstruction ; Ketamine ; Surgical Procedures, Minor ; Ventilation

Chronic intestinal pseudo-obstruction (CIPO) is a rare digestive syndrome characterized by symptoms and signs of intestinal obstruction in the absence of mechanical obstruction. A 48-year-old female presented at our facility with severe abdominal pain and vomiting. Simple abdominal radiography revealed small bowel gas and ileus. Computed tomography also revealed a dilated small bowel, but there was no evidence of mechanical obstruction. Esophageal function was decreased based on high-resolution manometry and the gastric emptying time was prolonged on a gastric emptying scan. The patient recovered with conservative treatment. We report a case of chronic intestinal pseudo-obstruction with esophageal and gastric dysfunction.
Abdominal Pain ; Female ; Gastric Emptying ; Humans ; Ileus ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction ; Manometry ; Middle Aged ; Radiography, Abdominal ; Vomiting

Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome, is a rare clinical syndrome of massive large bowel dilatation without mechanical obstruction, which may cause significant morbidity and mortality. Treatment focuses on decompressing a severely dilated colon. The proposed theory that this severe ileus results from an imbalance in the autonomous regulation of colonic movement supports the rationale for using neostigmine, a reversible acetylcholinesterase inhibitor, in patients who failed conservative care. Although gastrointestinal complications are frequent following allogeneic stem cell transplantation (SCT), the incidence of ACPO in a transplant setting is unknown and, if not vigilant, this adynamic ileus can be underestimated. We describe the case of a patient with myelodysplastic syndrome undergoing non-myeloablative allogeneic SCT from a partially human leukocyte antigen-mismatched sibling donor, and whose clinical course was complicated by ACPO in the early post-engraftment period. The ileus was not associated with gut graft-versus-host disease or infectious colitis. After 3 days of conservative care, intravenous neostigmine (2 mg/day) was administered for 3 consecutive days. Symptoms and radiologic findings began to improve 72 hours after the initial injection of neostigmine, and complete response without any associated complications was achieved within a week. Thus, neostigmine can be a safe medical therapy with successful outcome for patients who develop ACPO following allogeneic SCT.
Acetylcholinesterase ; Colitis ; Colon ; Colonic Pseudo-Obstruction ; Dilatation ; Graft vs Host Disease ; Humans ; Ileus ; Incidence ; Leukocytes ; Myelodysplastic Syndromes ; Neostigmine ; Siblings ; Stem Cell Transplantation ; Stem Cells ; Tissue Donors ; Transplants