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Ogilvie's Syndrome or Colonic Pseudo-Obstruction

In 1948, William Heneage Ogilvie described two patients with malignancy with colonic pseudo-obstruction, thus coining the term Ogilvie’s syndrome. Subsequently, the term was used by Dudley to describe functional obstruction of the colon. The term colonic pseudo-obstruction was subsequently first used in the medical literature in 1982. The term acute colonic pseudo-obstruction (ACPO) is now used.1 ACPO describes massive distension of the colon without a mechanical obstruction. Clinically, the causes vary, and include previous surgery, electrolyte imbalance, neurological conditions, medications, sepsis, cancers, trauma and burns, and a variety of miscellaneous conditions.2 The average age of the patients is 61 years. Diagnosis of ACPO includes physical examination, demonstrating distention without peritoneal signs plain abdominal X-rays showing massively enlarged colon CT scan showing dilated colon without perforation and no signs of a mass explaining the obstruction. Laboratory data likely will show electrolyte abnormalities with hypokalemia being the most common. Treatment includes nasogastric (NGT) decompression, electrolyte and fluid replacement, treatment of the underlying condition, avoiding contributing drugs such as narcotics and gastroenterology (GI) and/or surgery consult for further management.