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Acute pseudo-obstruction in critically ill patients with burns
K Kadesky1, G F Purdue, J L Hunt
1University of Texas Southwestern Medical Center, Dallas 75235-9031, USA.
The Journal of Burn Care & Rehabilitation
|March 1, 1995
Summary
Ogilvie's syndrome, a rare colon obstruction, affects critically ill burn patients. Non-burn factors like age and heart issues, not the burn itself, increase its incidence.
Area of Science:
- Gastroenterology
- Critical Care Medicine
- Surgery
Background:
- Acute pseudo-obstruction of the colon, or Ogilvie's syndrome, is a rare but serious complication in critically ill burn patients.
- The condition involves a non-obstructive dilation of the colon.
Purpose of the Study:
- To determine the incidence and characteristics of Ogilvie's syndrome in critically ill burn patients.
- To identify risk factors and evaluate treatment outcomes for Ogilvie's syndrome in this population.
Main Methods:
- A retrospective review of 2,703 consecutive critically ill burn patients was conducted.
- Patients diagnosed with pseudo-obstruction were identified and their clinical data analyzed.
Main Results:
- Eight patients (0.29%) were diagnosed with Ogilvie's syndrome.
- The average age was 63.5 years, with an average burn size of 24.6% TBSA.
- All affected patients were on mechanical ventilation; six had prior cardiac conditions, and five were on digoxin.
Conclusions:
- Ogilvie's syndrome in burn patients is associated with non-burn medical conditions, particularly cardiopulmonary issues and advanced age.
- Colonoscopic decompression is an effective primary treatment, with surgery reserved for refractory cases.
- The syndrome's occurrence appears linked to comorbidities rather than the burn injury severity itself.