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[Acute colonic pseudo-obstruction (Ogilvie's syndrome), a life-threatening complication after total hip replacement]
M Tezval1, S Sehmisch, C Dumont
1Klinik für Unfallchirurgie, Plastische und Wiederherstellungschirurgie der Universitätsklinik Göttingen, Göttingen. mtezval@med.uni-goettingen.de
Introduction:
In the literature, an acute colonic pseudo-obstruction (Ogilvie's syndrome) is frequently observed as a complication after hip arthroplasty. It results in a massive colon dilatation without mechanical obstructions and can lead to a life-threatening colon perforation with a high mortality.
Case Report:
We report on a 81-year-old male patient who suffered from an acetabular fracture after falling down with a concomitant coxarthrosis at the same hip side. A total hip arthroplasty was performed using a Müller cap. Postoperatively, he developed an acute colonic pseudo-obstruction that was treated conservatively with multiple colonoscopic decompressions. The importance of prompt recognition, careful monitoring and appropriate management to reduce morbidity and mortality are supported by this case.
Conclusion:
Early diagnosis and colonoscopic decompressions play a key role in the therapy for Ogilvie's syndrome. In case of a failure of conservative treatment or peritonism, an early laparotomy and coecostomy are necessary.
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