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Pseudo-obstruction in the critically ill.

Silvia Delgado-Aros1, Michael Camilleri

  • 1Clinical Enteric Neuroscience Translational and Epidemiological Research Program, Mayo Clinic, 200 First Street SW, Charlton 8-110, Rochester, MN 55905, USA.

Best Practice & Research. Clinical Gastroenterology
|May 24, 2003
PubMed
Summary
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Acute intestinal pseudo-obstruction, or Ogilvie's syndrome, causes massive bowel distension without mechanical blockage. Treatment aims to prevent perforation, a complication with a 21% mortality rate.

Area of Science:

  • Gastroenterology
  • Surgical Critical Care

Background:

  • Intestinal pseudo-obstruction presents as impaired intestinal propulsion without mechanical obstruction.
  • It can affect the small and/or large bowel in acute, subacute, or chronic forms.
  • Ogilvie's syndrome is a specific type of acute intestinal pseudo-obstruction.

Purpose of the Study:

  • To systematically review acute intestinal pseudo-obstruction (Ogilvie's syndrome).
  • To focus on mechanisms, manifestations, and management in postsurgery and critically ill patients.
  • To highlight the risks associated with massive intestinal distension.

Main Methods:

  • Systematic literature review of acute pseudo-obstruction.
  • Focus on patients with underlying clinical conditions, including postsurgery and critically ill individuals.

Related Experiment Videos

  • Analysis of proposed pathophysiological mechanisms, clinical manifestations, and treatment strategies.

    • Main Results:

    • Massive intestinal distension is the hallmark, detectable via clinical inspection and radiography.
    • Pathophysiological mechanisms remain incompletely understood.
    • Treatment primarily focuses on preventing intestinal perforation.

    Conclusions:

    • Acute intestinal pseudo-obstruction (Ogilvie's syndrome) requires careful management.
    • Preventing intestinal perforation is critical due to its high associated mortality rate (21%).
    • Further research into underlying mechanisms may improve therapeutic strategies.