Colonoscopic decompression and intubation of the cecum for Ogilvie's syndrome

Cecal distention due to pseudo-obstruction of the left colon may result in perforation or necrosis of the right colon with catastrophic consequences. This problem occurs in people who are ill from other causes; therefore, the mortality and morbidity is high in Ogilvie's syndrome whether treated operatively or nonoperatively. The treatment of choice has been tube cecostomy when cecal diameter exceeds 12 cm on supine films. Fiberoptic colonoscopy has provided a new treatment modality for this condition. The cecum can be decompressed safely in most cases. Recurrent distention can be avoided by transanal intubation of the cecum. A case is discussed, and the technique of cecal intubation is described.