[Ogilvie's syndrome and non-mechanical obstructions]

Ogilvie's syndrome and chronic intestinal pseudo-obstructions are two aspects of non-mechanical obstruction. The syndrome consists of acute colonic obstruction due to multiple causes and is characterized by passive dilatation of the colon without downstream obstacle. Treatment is primarily medical, except in cases with complications such as perforation by symptomatic treatment and, sometimes, by decompression colonoscopy. The most severe complication is perforation of the colon which may require colonic excision. Chronic intestinal pseudo-obstruction is characterized by chronic disorders mostly due to abnormalities of nervous plexuses and smooth muscle of the small and large bowels. It occurs in children and surgical abstention may lead to repeated but unfortunately ineffective operations. The only treatment recognized is digestive tract bypass combined with total parenteral feeding.