Pseudo-colonic obstruction after lumbar spine surgery: a case report

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Surgical Complications

Background:

• Acute colonic pseudo-obstruction (Ogilvie's syndrome) is characterized by massive colonic dilation without mechanical obstruction.
• Its pathophysiology is poorly understood but may involve autonomic nervous system imbalance affecting colon innervation.
• The condition is recognized in orthopedic surgery contexts, with trauma and spinal procedures implicated.

Observation:

• A case of Ogilvie's syndrome following lumbar spine surgery is presented.
• The patient experienced abdominal distension and significant colonic dilatation.
• Initial medical management, including parasympathomimetic agents, proved ineffective.

Findings:

• Ogilvie's syndrome can occur as a complication of lumbar spine surgery.
• Surgical intervention (right colectomy) was required due to treatment failure.
• This case underscores the need to consider neurological and surgical factors in pseudo-obstruction.

Implications:

• Spine surgery, particularly lumbar procedures, should be recognized as a potential trigger for Ogilvie's syndrome.
• Early recognition and consideration of surgical intervention are crucial for refractory cases.
• Further research into the neuro-enteric mechanisms underlying post-surgical pseudo-obstruction is warranted.