Acute Colonic Pseudo-Obstruction: A Case of Ogilvie Syndrome

Ogilvie syndrome is a pseudo-obstruction of the large colon that does not contain any mechanical obstruction. This is a case of a 32-year-old female who presented to the emergency department (ED) for acute onset vomiting and intermittent watery diarrhea. Based on her presentation, physical exam, and computed tomography (CT) findings, she was diagnosed with Ogilvie syndrome. The pathophysiology of Ogilvie syndrome involves a disruption of normal colonic motility, leading to excessive gas and fluid accumulation. Abdominal imaging typically reveals a massively dilated colon with no evident obstructive lesion. Initial management is conservative and includes supportive measures such as bowel rest and decompression, and may include medications to enhance colonic motility. In severe cases, endoscopic or surgical intervention to relieve symptoms and prevent complications such as bowel ischemia or perforation may be necessary. Identifying and addressing underlying precipitating factors is crucial for effective treatment and preventing recurrence.