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Ogilvie's syndrome
Summary
Ogilvie syndrome, a form of acute colonic pseudo-obstruction, can occur postpartum after cesarean delivery. A cecal diameter over 9.0 cm indicates surgery to prevent perforation.
Area of Science:
- Gastroenterology
- Obstetrics & Gynecology
- Surgical Oncology
Background:
- Ogilvie syndrome (acute colonic pseudo-obstruction) is a rare condition.
- Postpartum onset following cesarean section and hysterectomy is uncommon.
Observation:
- Four cases of Ogilvie syndrome in the early puerperium after cesarean section/hysterectomy are presented.
- Three patients had conservative management for cecal distention < 9.0 cm.
- One patient with cecal distention ≥ 9.0 cm underwent surgical intervention.
Findings:
- A cecal diameter of 9.0 cm or greater is a critical indicator for surgical intervention.
- Surgical intervention is also indicated for colonic perforation or failed conservative management.
- Early diagnosis and prompt management are crucial for preventing complications.
Implications:
- This case series highlights the importance of recognizing Ogilvie syndrome in the postpartum period.
- Establishing clear surgical criteria (cecal diameter ≥ 9.0 cm) can guide timely intervention.
- Preventing colonic perforation and reducing mortality associated with this condition are key goals.