An Ogilvie's syndrome: a rare case of large bowel pseudo-obstruction

Ogilvie's Syndrome (OS) is a rare but serious functional disorder characterized by dilatation of the colon, typically affecting the cecum and right colon, in the absence of any mechanical obstruction.

We present an unusual case of Ogilvie's Syndrome in a 67-year-old female patient following elective dynamic hip screw surgery. She presented with gradual abdominal distention, as well as gas and stool retention. On the ninth postoperative day, abdominal examination revealed significant distention, marked tympanitic sounds upon percussion, diffuse tenderness on palpation, diminished bowel sounds, and moderate abdominal pain. Investigation tools demonstrated gross dilated in colons, up to 92.4 mm at the cecum level by Abdominal CT which, confirming the diagnosis of Ogilvie's Syndrome. The team opted for conservative treatment, including nasogastric tube (NGT) insertion, fasting, and intravenous fluids. Subsequent imaging a few days later indicated a reduction in colonic diameter (cecum measuring 38 mm) and an improvement in the patient's overall condition.

Although Ogilvie's Syndrome is infrequently encountered, clinicians should maintain a high index of suspicion for gas and stool retention following surgical procedures. It is essential to be familiar with diagnostic methods and management protocols for this condition.