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[Ogilvie syndrome after Cesarean section]
B T Schjoldager1, J L Sørensen, T Svaerke
1Hillerød Sygehus, gynaekologisk-obstetrisk afdeling.
Introduction:
Ogilvie's syndrome, acute pseudo-obstruction of the colon, can lead to perforation of the caecum and death. The syndrome is not well known and diagnosis can be difficult to make in time.
Methods:
We analysed seven cases of Ogilvie's syndrome with the aim of improving diagnostics.
Results:
All had prolonged labour before cesarean section, which was complicated by bleeding. All were treated with syntocinon, a hormone that may influence gastrointestinal motility. All patients developed abdominal meteorism within a few days of operation, which increased despite the passing of flatus and stool. Five cases resulted in caecum perforation before the correct diagnosis and treatment were made. Perforation occurred on days 3-4, day 5, or probably days 8-10 after the operation. One of these patients, who suffered from severe adipositas, died.
Conclusion:
It is very important to make an early diagnosis, as the condition can progress quickly. Diagnosis should be made on the history, clinical assessment, and abdominal X-ray. Intermittent flatus and stool are characteristic of this truly non-obstructive condition and should not therefore delay a diagnostic X-ray.