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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
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Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents01:17

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Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

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Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
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Postoperative Ileus Murine Model
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Ogilvie's syndrome-acute colonic pseudo-obstruction.

P Pereira1, F Djeudji2, P Leduc2

  • 1Service de chirurgie digestive et de colo-proctologie, hospices civils de Lyon, hopital Edouard-Herriot, 5, place d'Arsonval, 69437 Lyon cedex 09, France; Université Claude-Bernard, Lyon I, 8, avenue Rockefeller, 69374 Lyon cedex 08, France.

Journal of Visceral Surgery
|March 16, 2015
PubMed
Summary

Ogilvie's syndrome, or acute colonic pseudo-obstruction, is a serious condition of colon dilation without mechanical blockage. Early conservative treatment and decompression are key, with surgery reserved for severe or refractory cases.

Keywords:
Acute colonic pseudo-obstruction syndromeCecostomyColonic exsufflationCut-offNeostigmineOgilvie's syndrome

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Abdominal Imaging

Background:

  • Ogilvie's syndrome (acute colonic pseudo-obstruction) presents as colonic and rectal dilation without mechanical obstruction.
  • Pathophysiology remains poorly understood, often affecting debilitated patients.
  • Computed tomography (CT) is crucial for differentiating from organic obstruction by identifying a characteristic 'cut-off' sign.

Purpose of the Study:

  • To review the diagnostic and therapeutic strategies for Ogilvie's syndrome.
  • To outline conservative, pharmacologic, and surgical management options.
  • To emphasize the importance of excluding mechanical obstruction and managing risk factors for perforation.

Main Methods:

  • Initial assessment involves excluding mechanical obstruction via imaging (CT scan).
  • Conservative management includes fluid resuscitation and bowel rest.
  • Pharmacologic treatment with neostigmine is indicated for non-severe cases; colonic decompression is favored for high-risk cecal dilation.

Main Results:

  • Conservative and pharmacologic therapies, including neostigmine and gas decompression, are effective for Ogilvie's syndrome.
  • Recurrence can be prevented with rectal tubes and laxatives like polyethylene glycol (PEG).
  • Alternative treatments like epidural anesthesia and needle decompression exist, but surgery has high morbidity.

Conclusions:

  • Ogilvie's syndrome requires prompt diagnosis to differentiate from mechanical obstruction.
  • A stepwise approach, starting with conservative and pharmacologic treatments, is recommended.
  • Surgery is a last resort due to associated high morbidity and mortality rates.