Ogilvie syndrome as a postoperative complication

Area of Science:

• Gastroenterology
• Surgical Complications
• Abdominal Surgery

Background:

• Ogilvie syndrome (acute colonic pseudo-obstruction) is a known postoperative complication.
• Previous literature suggests associations with gynecologic, abdominal, pelvic, and orthopedic procedures.

Purpose of the Study:

• To identify patient populations at higher risk for developing Ogilvie syndrome.
• To analyze the types of surgical procedures and trauma associated with Ogilvie syndrome.
• To evaluate treatment outcomes for Ogilvie syndrome.

Main Methods:

• A case series design was employed, reviewing medical records of patients diagnosed with Ogilvie syndrome between 1989 and 1998.
• Data collected included patient history, treatments, cecal diameter, and outcomes.
• Statistical analysis aimed to identify risk factors and common preceding procedures.

Main Results:

• Ogilvie syndrome affected 36 patients (mean age 68.9 years), predominantly men (24/36).
• Coronary artery bypass grafting (25%) was the most frequent procedure, followed by orthopedic/spinal (38.9%) and cardiothoracic (33.3%) surgeries.
• Conservative treatment succeeded in 52.8% of cases; colonoscopic decompression had a 77% success rate. Surgical intervention was required in 5 patients, with a 60% mortality rate.

Conclusions:

• While orthopedic and spinal procedures increase risk, coronary artery bypass grafting is the most common precipitating factor for Ogilvie syndrome.
• Cardiothoracic, orthopedic, and neurosurgeons must be aware of this complication in patients with postoperative abdominal distension.
• Early diagnosis and appropriate management, preferably non-operative, are crucial, as surgical intervention carries a high mortality risk.