Diseases of the Colon & Rectum

, Volume 40, Issue 11, pp 1353–1357 | Cite as

Early resolution of Ogilvie's syndrome with intravenous neostigmine

A simple, effective treatment
  • F. Turégano-Fuentes
  • F. Muñoz-Jiménez
  • E. Del Valle-Hernández
  • D. Pérez-Díaz
  • M. Calvo-Serrano
  • J. De Tomás
  • M. L. De Fuenmayor
  • A. Quintans-Rodríguez
Original Contributions
  • 154 Downloads

Abstract

PURPOSE: Our aim was to assess the value of a parasympathomimetic drug (neostigmine) in the early resolution of acute colonic pseudo-obstruction (Ogilvie's syndrome). METHODS: A prospective study was undertaken in 18 consecutive patients (mean age, 76 (range, 31–87) years) with acute colonic pseudo-obstruction. After a varying period of conservative treatment in all cases, 16 patients with persistent, massive abdominal distention were given intravenous neostigmine. RESULTS: A rapid and satisfactory clinical and radiologic decompression of the large bowel was obtained in 12 patients (75 percent) after a single dose of the drug; another patient had complete resolution after a second dose, and the other 3 patients had only partial resolution, in one of them after a second dose of the drug. No patient required surgical decompression of the bowel. CONCLUSION: These results give support to the theory of excessive parasympathetic suppression in most cases of Ogilvie's syndrome. The treatment with intravenous neostigmine has proved very effective, preventing in many cases prolonged periods of uncomfortable and potentially hazardous conventional conservative management and avoiding surgical treatment in a consecutive series of patients.

Key words

Colonic pseudo-obstruction Ogilvie's syndrome Colonic decompression Neostigmine 

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References

  1. 1.
    Dorudi S, Berry AR, Kettlewell MG. Acute colonic pseudo-obstruction. Br J Surg 1992;79:99–103.PubMedGoogle Scholar
  2. 2.
    Datta SN, Havard TJ, Stephenson BM, Salaman JR. Acute colonic pseudo-obstruction [letter]. Lancet 1993;341:690.Google Scholar
  3. 3.
    Vanek VW, Al-Salti M. Acute pseudo-obstruction of the colon (Ogilvie's syndrome): an analysis of 400 cases. Dis Colon Rectum 1986;29:203–10.PubMedGoogle Scholar
  4. 4.
    Stephenson BM, Morgan AR, Salaman JR, Wheeler MH. Ogilvie's syndrome: a new approach to an old problem. Dis Colon Rectum 1995;38:424–7.PubMedGoogle Scholar
  5. 5.
    Hutchinson R, Griffiths C. Acute colonic pseudo obstruction: a pharmacological approach. Ann R Coll Surg Engl 1992;74:364–7.PubMedGoogle Scholar
  6. 6.
    Stephenson BM, Morgan AR, Drake N, Salaman JR, Wheeler MH. Parasympathomimetic decompression of acute colonic pseudo-obstruction. Lancet 1993;342:1181–2.Google Scholar
  7. 7.
    Ohri SK, Patel T, Desa L, Spencer J. Drug-induced colonic pseudo-obstruction: report of a case. Dis Colon Rectum 1991;34:346–50.Google Scholar
  8. 8.
    Bianchi A, Ubach M. Seudoobstrucción aguda de colon por opiáceos tratada con naloxona [letter], Med Clín (Barc) 1994;103:78.Google Scholar
  9. 9.
    Ogilvie H. Large-intestine colic due to sympathetic deprivation: a new clinical syndrome. BMJ 1948;2:671–3.Google Scholar
  10. 10.
    Schuffler MD, Deitch EA. Chronic idiopathic intestinal pseudo-obstruction: a surgical approach. Ann Surg 1980;192:752–61.PubMedGoogle Scholar
  11. 11.
    Nivatvongs S, Vermeulien FD, Fang DT. Colonoscopic decompression of acute pseudo-obstruction of the colon. Ann Surg 1982;196:598–600.PubMedGoogle Scholar
  12. 12.
    Groff W. Colonoscopic decompression and intubation of the cecum for Ogilvie's syndrome. Dis Colon Rectum 1983;26:503–6.PubMedGoogle Scholar
  13. 13.
    Lee JT, Taylor BM, Singleton BC. Epidural anesthesia for acute pseudo-obstruction of the colon (Ogilvie's syndrome). Dis Colon Rectum 1988;31:686–91.PubMedGoogle Scholar
  14. 14.
    Acea Nebril B, Parajó Calvo A, Taboada Filgueira L, Sánchez González F, Blanco Freire N. Indicaciones quirurgicas en la pseudoobstrucción aguda de colon (síndrome de Ogilvie). Rev Esp Enferm Dig 1993;84:197–9.PubMedGoogle Scholar
  15. 15.
    Munro A, Youngson GC. Colonoscopy in the diagnosis and treatment of colonic pseudo-obstruction. J R Coll Surg Edinb 1983;28:391–3.PubMedGoogle Scholar

Copyright information

© American Society of Colon and Rectal Surgeons 1997

Authors and Affiliations

  • F. Turégano-Fuentes
    • 1
  • F. Muñoz-Jiménez
    • 1
  • E. Del Valle-Hernández
    • 1
  • D. Pérez-Díaz
    • 1
  • M. Calvo-Serrano
    • 1
  • J. De Tomás
    • 1
  • M. L. De Fuenmayor
    • 1
  • A. Quintans-Rodríguez
    • 1
  1. 1.Emergency Department (Surgical Section), General Surgery I Service (Colorectal Unit)University General Hospital “Gregorio Marañón”MadridSpain

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