Pearls and Pitfalls
Colonic pseudo-obstruction refers to a clinical syndrome of colonic dilation in the absence of a mechanical obstruction; the presentation may mimic an acute large bowel obstruction.
Pseudo-obstruction occurs primarily in hospitalized patients, with an incidence as high often >20% after selected surgical procedures or trauma.
The pathogenesis of this syndrome is not fully elucidated; however, an imbalance in the autonomic regulation of the colon has been suggested.
Physical findings include a distended, tympanitic abdomen with present but diminished bowel sounds.
When combined with clinical examination, abdominal x-rays are usually diagnostic or highly suspicious.
Colon ischemia and subsequent perforation, which occurs in 3–15% of patients, is the most important complication and has a mortality of about 50%.
The radiographic findings are of marked distention of the proximal colon with the descending and sigmoid colon of normal caliber.
A water-soluble contrast enema...
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Selected Readings
Chevallier P, Marcy PY, Francois E, et al. (2002) Controlled transperitoneal percutaneous cecostomy as a therapeutic alternative to the endoscopic decompression for Ogilvie's syndrome. Am J Gastroenterol 97:471–474
De Giorgio R, Barbara G, Stanghellini V, et al. (2001) Review article: the pharmacological treatment of acute colonic pseudo-obstruction. Aliment Pharmacol Ther 15:1717–1727
Eisen GM, Baron TH, Dominitz JA, et al. (2002) Acute colonic pseudo-obstruction. Gastrointest Endosc 56:789–792
Mehta R, John A, Nair P, et al. (2006) Factors predicting successful outcome following neostigmine therapy in acute colonic pseudo-obstruction: a prospective study. J Gastroenterol Hepatol 21:459–461
Ponec RJ, Saunders MD, Kimmey MB (1999) Neostigmine for the treatment of acute colonic pseudo-obstruction. N Engl J Med 341:137–141
Saunders MD, Cappell MS (2005) Endoscopic management of acute colonic pseudo-obstruction. Endoscopy 37:760–763
Saunders MD, Kimmey MB (2005) Systematic review: acute colonic pseudo-obstruction. Aliment Pharmacol Ther 22:917–925
Sgouros SN, Vlachogiannakos J, Vassiliadis K, et al. (2006) Effect of polyethylene glycol electrolyte balanced solution on patients with acute colonic pseudo obstruction after resolution of colonic dilation: a prospective, randomised, placebo controlled trial. Gut 55:638–642
Tenofsky PL, Beamer L, Smith RS (2000) Ogilvie syndrome as a postoperative complication. Arch Surg 135:682–686; discussion 686–687
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2009 Springer Science+Business Media, LLC
About this entry
Cite this entry
Bosio, R.M., Senagore, A.J. (2009). Acute Colonic Pseudo-Obstruction. In: Bland, K.I., Büchler, M.W., Csendes, A., Sarr, M.G., Garden, O.J., Wong, J. (eds) General Surgery. Springer, London. https://doi.org/10.1007/978-1-84628-833-3_71
Download citation
DOI: https://doi.org/10.1007/978-1-84628-833-3_71
Publisher Name: Springer, London
Print ISBN: 978-1-84628-832-6
Online ISBN: 978-1-84628-833-3
eBook Packages: MedicineReference Module Medicine