Ogilvie syndrome

The pseudo-obstruction (including Intestinal pseudo-obstruction ) of the intestine is a technical term from the medicine. It refers to a mechanical cause usually without massively bloated, functional motionless ( = atonic ) intestine. This condition also occurs during mechanical bowel obstruction. Has first described the disease in 1948 Heneage Ogilvie, hence the term Ogilviesyndrom is used synonymously. The disease is rare, severe and occurs mainly in the elderly, after an operation or under other very serious diseases. There is no such cause and the state remains exist, it is called Chronic Intestinal pseudo-obstruction ( CIPO ).

Symptoms

Patients complain of Stuhlverhalt, more or less severe pain in the abdomen and show a massive abdominal distension. If complications arise, it can very quickly lead to a circulatory shock or respiratory arrest.

Cause

The etiology and pathogenesis of Ogilvie 's syndrome are unclear. The cause of a malfunction of the autonomic nervous system is assumed with increased sympathetic activity. Sometimes it occurs as a result of trauma, after surgery in the abdomen or pelvis, with different internal medicine diseases such as chronic bronchitis reason or for no apparent reason. In chronic gastrointestinal pseudo-obstruction also may be a paraneoplastic syndrome.

Diagnostics

The diagnosis of the disease is easy because the X-ray image has very distinctive character. The entire colon is wide filled with air, in particular, the ascending portion of the colon reaches a width of often more than 10 cm.

• X-ray of the abdomen while standing
• Barium enema
• Colonoscopy
• Computed tomography of the abdomen

Differential diagnosis, constipation, a mechanical ileus, a toxic megacolon and a Sigmavolvulus be considered.

Complications

The complication rate and mortality of the disease are high when it is not possible to remove the air from the colon. As a complication following may occur:

• Perforation ( perforation of the intestinal wall )
• Intestinal ischemia ( circulatory disorder of the intestinal wall )
• Respiratory failure due to the elevation of the diaphragm ( breathing impairment )

Therapy

• Pharmacological actions: Acetylcholinesterase inhibitors neostigmine or pyridostigmine
• Intravenous fluid administration