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1.
Article in English | WPRIM | ID: wpr-765626

ABSTRACT

STUDY DESIGN: Case report. OBJECTIVES: We report a case of Ogilvie's syndrome following posterior decompression surgery in a spinal stenosis patient who presented with acute abdominal distension, nausea, and vomiting. SUMMARY OF LITERATURE REVIEW: Ogilvie's syndrome is a rare and potentially fatal disease that can easily be mistaken for postoperative ileus, and is also known as acute colonic pseudo-obstruction. Early recognition and diagnosis enable treatment prior to bowel perforation and requisite abdominal surgery. MATERIALS AND METHODS: An 82-year-old woman presented with 6 months of worsening back pain with walking intolerance due to weakness in both legs. She had hypertension, asthma, and Cushing syndrome without bowel or bladder symptoms. Further workup demonstrated the presence of central spinal stenosis on magnetic resonance imaging. The patient underwent an L2-3 laminectomy and posterior decompression. Surgery was uneventful. RESULTS: The patient presented with acute abdominal distension, nausea, and vomiting on postoperative day 1. The patient was initially diagnosed with adynamic ileus and treated conservatively with bowel rest, reduction in narcotic dosage, and a regimen of stool softeners, laxatives, and enemas. Despite this treatment, her clinical course failed to improve, and she demonstrated significant colonic distension radiographically. Intravenous neostigmine was administered as a bolus with a rapid and dramatic response. CONCLUSION: Ogilvie's syndrome should be included in the differential diagnosis of postoperative ileus in patients developing prolonged unexplained abdominal distension and pain after lumbar spinal surgery. Early diagnosis and initiation of conservative management can prevent major morbidity and mortality due to bowel ischemia and perforation.


Subject(s)
Aged, 80 and over , Asthma , Back Pain , Colon , Colonic Pseudo-Obstruction , Cushing Syndrome , Decompression , Diagnosis , Diagnosis, Differential , Early Diagnosis , Enema , Female , Humans , Hypertension , Ileus , Ischemia , Laminectomy , Laxatives , Leg , Magnetic Resonance Imaging , Mortality , Nausea , Neostigmine , Spinal Stenosis , Urinary Bladder , Vomiting , Walking
2.
Article in English | WPRIM | ID: wpr-740765

ABSTRACT

BACKGROUND/AIMS: Previous studies from Korea have described chronic intestinal pseudo-obstruction (CIPO) patients with transition zone (TZ) in the colon. In this study, we evaluated the pathological characteristics and their association with long-term outcomes in Korean colonic pseudo-obstruction (CPO) patients with TZ. METHODS: We enrolled 39 CPO patients who were refractory to medical treatment and underwent colectomy between November 1989 and April 2016 (median age at symptoms onset: 45 [interquartile range, 29–57] years, males 46.2%). The TZ was defined as a colonic segment connecting a proximally dilated and distally non-dilated segment. Detailed pathologic analysis was performed. RESULTS: Among the 39 patients, 37 (94.9%) presented with TZ and 2 (5.1%) showed no definitive TZ. Median ganglion cell density in the TZ adjusted for the colonic circumference was significantly decreased compared to that in proximal dilated and distal non-dilated segments in TZ (+) patients (9.2 vs 254.3 and 150.5, P < 0.001). Among the TZ (+) patients, 6 showed additional pathologic findings including eosinophilic ganglionitis (n = 2), ulcers with combined cytomegalovirus infection (n = 2), diffuse ischemic changes (n = 1), and heterotropic myenteric plexus (n = 1). During follow-up (median, 61 months), 32 (82.1%) TZ (+) patients recovered without symptom recurrence after surgery. The presence of pathological features other than hypoganglionosis was an independent predictor of symptom recurrence after surgery (P = 0.046). CONCLUSIONS: Hypoganglionosis can be identified in the TZ of most Korean CPO patients. Detection of other pathological features in addition to TZ-associated hypoganglionosis was associated with poor post-operative outcomes.


Subject(s)
Cell Count , Colectomy , Colon , Colonic Pseudo-Obstruction , Cytomegalovirus Infections , Eosinophils , Follow-Up Studies , Ganglion Cysts , Humans , Intestinal Pseudo-Obstruction , Korea , Male , Myenteric Plexus , Pathology , Recurrence , Ulcer
3.
Gastroenterol. latinoam ; 30(1): 21-25, 2019. ilus
Article in Spanish | LILACS | ID: biblio-1103777

ABSTRACT

Ogilvie syndrome, or Acute Colonic Pseudo-Obstruction (ACPO) is characterized by colonic distension in the absence of mechanical obstruction. In general, it evolves favorably following a conservative treatment, and surgical procedures are not necessary6. We describe a case of ACPO with evolution of two days, in a 79-year old male patient, with asthma, type 2 diabetes mellitus, systemic arterial hypertension and policystic kidneys. After failure of conservative treatment based on support measures and neostigmine, percutaneous endoscopic support cecostomy, using a gastrostomy tube. The technique and its early execution were chosen considering that it was easy to be implemented, low cost and need for immediate colonic decompression due to high risk of ischemia and perforation of the colon, associated to a rapid clinical deterioration of the patient


El síndrome de Ogilvie o Pseudoobstrucción colónica aguda (ACPO) se caracteriza por la distensión del colon en ausencia de obstrucción mecánica. En general, el tratamiento conservador es favorable, no siendo necesaria una intervención quirúrgica. Describimos el caso de una ACPO con dos días de evolución, en paciente masculino de 79 años, asmático, portador de diabetes mellitus tipo 2, hipertensión arterial sistémica y riñones poliquísticos. Después del fracaso del tratamiento conservador con medidas de soporte y neostigmina, se optó por la realización de cecostomía endoscópica percutánea de protección, utilizando una sonda de gastrostomía. La elección de la técnica y su realización precoz se dio teniendo en vista su facilidad de ejecución, su bajo costo y la necesidad de descompresión colónica inmediata por el elevado riesgo de isquemia y perforación del colon, asociado al rápido empeoramiento clínico del paciente.


Subject(s)
Humans , Male , Aged , Colonic Pseudo-Obstruction/surgery , Cecostomy/methods , Syndrome , Colonic Pseudo-Obstruction/diagnostic imaging , Gastrostomy , Tomography, X-Ray Computed , Cecum/surgery , Treatment Outcome
4.
Rev. cuba. pediatr ; 90(1): 149-157, ene.-mar. 2018. ilus
Article in Spanish | LILACS | ID: biblio-901474

ABSTRACT

Introducción: el síndrome de Ogilvie es una entidad infrecuente, más aún en la edad pediátrica, caracterizada por la dilatación aguda del colon, y que suele complicar la evolución de distintas enfermedades. Dentro de sus causas más comunes está la cirugía ortopédica y/o traumatológica. Objetivo: actualizar sobre el diagnóstico y tratamiento del síndrome en las edades pediátricas. Presentación del caso: se presenta una paciente de 16 años, operada de escoliosis toraco abdominal, que a las 24 horas de operada comenzó con distensión abdominal progresiva y marcada, y se le diagnosticó de síndrome de Ogilvie. Conclusiones: la entidad, aunque infrecuente, puede presentarse en pacientes con diversas afecciones, y se debe conocer adecuadamente sobre su diagnóstico y tratamiento para lograr la recuperación del enfermo(AU)


Introduction: Ogilvie syndrome is an uncommon condition, even more so in childhood. It is characterized by acute dilation of the colon, often complicating the evolution of different diseases. Its most frequent causes include orthopedic and/or trauma surgery. Objective: update the information about the diagnosis and treatment of the syndrome in pediatric ages. Case presentation: a female 16-year-old patient who had undergone thoraco-abdominal scoliosis surgery and had developed progressive, marked abdominal distension 24 hours after the operation, was diagnosed with Ogilvie syndrome. Conclusions: infrequent as it is, the condition may present in patients with various diseases. It is necessary to have adequate knowledge about its diagnosis and treatment to achieve successful recovery in patients(AU)


Subject(s)
Female , Adolescent , Colonic Pseudo-Obstruction/diagnosis , Colonic Pseudo-Obstruction/drug therapy , Intensive Care Units, Pediatric
5.
Medisan ; 22(2)feb. 2018.
Article in Spanish | LILACS | ID: biblio-894686

ABSTRACT

La seudoobstrucción colónica aguda o síndrome de Ogilvie es una afección en la cual hay apariencia clínica e imagenológica de obstrucción intestinal sin bloqueo mecánico. Se describe el caso clínico de una anciana de 65 años de edad, quien sufría esta condición clínica, por lo cual fue atendida en el Servicio de Cirugía del Hospital N´Gola Kimbanda, provincia Namibe en Angola e intervenida quirúrgicamente. La paciente evolucionó favorablemente y egresó sin dificultad


The acute colonic pseudo-obstruction or Ogilvie syndrome is a disorder in which there is a clinical and imagenologic appearance of intestinal obstruction without mechanic blockade. The case report of a 65 years old woman who suffered from this clinical condition is described, reason why she was assisted and surgically intervened in the Surgery Service of N´Gola Kimbanda Hospital, Namibe province in Angola. The patient had a favorable clinical course and she was discharged without difficulty


Subject(s)
Humans , Female , Aged , Colonic Pseudo-Obstruction/diagnosis , Colonic Pseudo-Obstruction/drug therapy , Intestinal Pseudo-Obstruction/surgery , Intestinal Obstruction
6.
Oncol. (Guayaquil) ; 27(3): 189-194, 30 diciembre 2017.
Article in Spanish | LILACS | ID: biblio-998922

ABSTRACT

Introducción: El síndrome de Ogilvie es una patología rara que se puede encontrar en pacientes que han sido sometidos a cirugías extensas dando un cuadro clínico de obstrucción intestinal, llegando a ser letal de no ser diagnosticada a tiempo. Existen varios tratamientos tanto farmacológicos, endoscópicos y quirúrgicos para descomprimir el colon. Caso clínico: Se presenta el caso de un paciente de 35 años intervenido quirúrgicamente de un meningioma que sufre de un cuadro de obstrucción intestinal posterior a la intervención catalogándose como un Síndrome de Ogilvie.


Introduction: Ogilvie syndrome is a rare condition that can be found in patients who have undergone extensive surgery giving a clinical picture of intestinal obstruction, becoming lethal if not diagnosed in time. There are several pharmacological, endoscopic and surgical treatments to decompress the colon. Clinical case: We present the case of a 35 year-old patient surgically operated on a meningioma suffering from a picture of intestinal obstruction following the intervention, being classified as an Ogilvie Syndrome. The case is presented by the low incidence of the same.


Subject(s)
Humans , General Surgery , Colonic Pseudo-Obstruction , Meningioma , Abdominal Pain , Colon , Patient Reported Outcome Measures
8.
Rev. cuba. cir ; 55(1): 0-0, ene.-mar. 2016. ilus
Article in Spanish | LILACS | ID: lil-781192

ABSTRACT

La pseudoobstrucción aguda del colon, también conocida como síndrome de Ogilvie, consiste en una dilatación aguda masiva del colon con una combinación de síntomas y signos de obstrucción colónica en ausencia de obstrucción mecánica. Aunque es una entidad clínica bien conocida, en muchos aspectos, aun es escasamente comprendida y continúa siendo un reto para clínicos y cirujanos. Su temprano reconocimiento y tratamiento apropiados son imprescindibles para minimizar la morbilidad y la mortalidad. Se presenta el caso de una paciente que desarrolló un cuadro clínico de evisceración poslaparotómica causada por la dilatación aguda masiva del colon de un síndrome de Ogilvie. Recibió tratamiento quirúrgico urgente y su recuperación fue satisfactoria. El objetivo de este trabajo es publicar una forma de presentación poco frecuente del síndrome de Ogilvie y la revisión de la literatura especializada(AU)


Acute colonic pseudo-obstruction, also known as Ogilvie's syndrome, refers to an acute massive colonic dilatation with combined symptoms and signs of colonic obstruction in the absence of mechanical obstruction. Although it is a well-known clinical entity, in many aspects it remains poorly understood and continues to challenge physicians and surgeons alike. Early recognition and appropriate management are critical to minimize morbidity and mortality. The case is presented of a female patient bearer of a post laparotomic evisceration caused by an acute massive colonic dilatation of Ogilvie's syndrome, who was submitted to urgent surgical treatment with full recovery. This paper is aimed at presenting an unusual way of onset of Ogilvie's syndromeand the review of the specialized literature(AU)


Subject(s)
Humans , Female , Aged , Colonic Pseudo-Obstruction/surgery , Colonic Pseudo-Obstruction/therapy , Review Literature as Topic
9.
Korean Journal of Medicine ; : 318-321, 2016.
Article in Korean | WPRIM | ID: wpr-165898

ABSTRACT

Acute colonic pseudo-obstruction (Ogilvie's syndrome) is a very rare complication of herpes zoster. A 62-year-old female visited our hospital due to abdominal pain. Skin lesions of herpes zoster had developed after the patient experienced symptoms of colonic obstruction. The symptoms of colonic obstruction resulted in more suffering for the patient than did those of herpes zoster. In cases reported previously in Korea, these symptoms were improved by endoscopic colonic decompression. However, the symptoms of this patient were improved by conservative treatment only, which included fasting and intravenous fluid replacement. Furthermore, this case differs from previous cases in terms of the difficulty of diagnosis due to the delayed appearance of the skin lesions. We present herein the first case in Korea of Ogilvie's syndrome as a complication of herpes zoster, which was improved by conservative treatment. Clinicians should be aware of the various unusual complications of herpes zoster.


Subject(s)
Abdominal Pain , Colon , Colonic Pseudo-Obstruction , Decompression , Diagnosis , Fasting , Female , Herpes Zoster , Humans , Korea , Middle Aged , Skin
10.
Article in English | WPRIM | ID: wpr-204976

ABSTRACT

Neostigmine can successfully decompress patients with acute colonic pseudo-obstruction (ACPO) who are unresponsive to conservative therapy. However, neostigmine is contraindicated in renal failure, so it is underused in ACPO patients with renal failure who would be otherwise appropriate candidates. We described the first successfully treated case of acute kidney injury (AKI) with neostigmine in a patient with ACPO. A 72-year-old man who underwent a coronary artery bypass graft surgery 11 days prior presented to the emergency room with abdominal distension, peripheral edema, and dyspnea on exertion. Plain abdominal radiographs and abdomen computed tomography scan showed diffuse colonic dilatation without obstruction. Serum creatinine level was increased five-fold over baseline. We diagnosed the patient as ACPO with AKI. With conservative treatment, renal function failed to improve because the ACPO was not corrected. Administration of neostigmine rapidly resolved ACPO and renal function, avoiding more invasive procedures such as colonoscopic decompression and hemodialysis. Neostigmine appears to be an effective and safe treatment option for ACPO patients with renal failure. Prospective large-scale studies should be carried out to determine the safety and efficacy of neostigmine in ACPO patients with renal failure.


Subject(s)
Acute Kidney Injury/drug therapy , Aged , Cardiac Surgical Procedures , Colonic Pseudo-Obstruction/complications , Creatinine/blood , Humans , Male , Neostigmine/therapeutic use , Radiography, Abdominal
11.
Article in English | WPRIM | ID: wpr-153428

ABSTRACT

Hypoganglionosis is a rare form of intestinal neuronal malformation, which is characterized by reduced number and size of ganglion cells of parasympathetic nerves in the intestinal wall. Pathophysiology is not well known, however intestinal ischemia, inflammation, autoimmune process or neurotoxin may play a role. Here, we report the case of a 56-year-old man with colonic pseudoobstruction and ulcerations in marked dilatedcolon above transitional zone who was later diagnosed with colonic hypoganglionosis.


Subject(s)
Colon , Colonic Pseudo-Obstruction , Ganglion Cysts , Humans , Inflammation , Ischemia , Middle Aged , Neurons , Ulcer
12.
Article in English | WPRIM | ID: wpr-21890

ABSTRACT

BACKGROUND/AIMS: Chronic intestinal pseudo-obstruction (CIPO) is a disorder characterized by recurrent symptoms suggestive of obstruction such as abdominal pain, proximal distension with extremely suppressed motility in the absence of lumen-occluding lesion, whose etiology/pathophysiology is poorly understood. In this study we investigated a functionally obstructive lesion that could underlie symptoms of CIPO. METHODS: We studied colons surgically removed from 13 patients exhibiting clinical/pathological features of pseudo-obstruction but were unresponsive to standard medical treatments. The colons were characterized morphologically, functionally and molecularly, which were compared between regions and to 28 region-matched controls obtained from colon cancer patients. RESULTS: The colons with pseudo-obstruction exhibited persistent luminal distension proximally, where the smooth muscle was hypertrophied with changes in the cell phenotypes. Distinct luminal narrowing was observed near the distal end of the dilated region, close to the splenic flexure, previously referred to as the "transition zone (TZ)" between the dilated and non-dilated loops. Circular muscles from the TZ responded less to depolarization and cholinergic stimulation, which was associated with down-regulation of L-type calcium channel expression. Smooth muscle contractile protein was also downregulated. Myenteric ganglia and neuronal nitric oxide synthase (nNOS) positive cells were deficient, more severely in the TZ region. Interstitial cells of Cajal was relatively less affected. CONCLUSIONS: The TZ may be the principal site of functional obstruction, leading to proximal distension and smooth muscle hypertrophy, in which partial nNOS depletion could play a key role. The neuromuscular abnormalities probably synergistically contributed to the extremely suppressed motility observed in the colonic pseudo-obstruction.


Subject(s)
Abdominal Pain , Calcium Channels, L-Type , Colon , Colon, Transverse , Colonic Neoplasms , Colonic Pseudo-Obstruction , Constipation , Down-Regulation , Ganglia , Humans , Hypertrophy , Interstitial Cells of Cajal , Intestinal Pseudo-Obstruction , Muscle, Smooth , Muscles , Nitric Oxide , Nitric Oxide Synthase Type I , Phenobarbital , Phenotype
13.
Repert. med. cir ; 23(1): 67-71, 2014. tab
Article in Spanish | LILACS | ID: lil-795659

ABSTRACT

El síndrome de Ogilvie es una condición clínica con signos, síntomas y hallazgos radiográficos de obstrucción intestinal sin una causa mecánica. La fisiopatología es aún desconocida, se sugiere un disbalance entre la inervación simpática y parasimpática del colon. Se asocia con una extensa gama de comorbilidades incluyendo trauma, cirugía pélvica (ortopédica, ginecológica, urológica), alteraciones metabólicas o del sistema nervioso central, así como medicamentos en especial antipsicóticos atípicos como clozapina. Sin el diagnóstico y tratamiento oportunos puede progresar a perforación intestinal, peritonitis e incluso la muerte. Se analizan las historias clínicas de tres pacientes tratados por pseudoobstrucción intestinal (síndrome de Ogilvie) en la Clínica San Juan de Dios de Chía, Colombia, en 2011, que requirieron remisión para manejo médico o quirúrgico. Se consideró como causa desencadenante el uso crónico del antipsicótico clozapina...


Ogilvie´s syndrome is a clinical condition with signs, symptoms and radiographic appearance of intestinal obstruction without a mechanical cause. Pathophysiology is still unknown. An imbalance between sympathetic and parasympathetic colonic innervation is suggested. It is associated with an extent range of comorbidities including trauma, pelvic surgery (orthopedic, gynecologic, urologic), metabolic alterations or central nervous system alterations, as well as in patients receiving medication especially atypical anti-psychotic agents such as clozapine. Prompt diagnosis and treatment are critical to avoid progression to bowel perforation, peritonitis and even death. Clinical records of 3 patients treated for bowel pseudo-obstruction (Ogilvie´s Syndrome) at San Juan de Dios Clinic in Chía, Colombia, in 2011, who needed referral for medical or surgical treatment, were analyzed. Chronic use of clozapine, an antipsychotic agent, was considered the triggering cause. Peritonitis and bowel perforation was the most serious complication. There was no mortality attributable to this syndrome or its management...


Subject(s)
Humans , Colonic Pseudo-Obstruction , Intestinal Obstruction , Intestinal Pseudo-Obstruction , Peritonitis
14.
Article in English | WPRIM | ID: wpr-62192

ABSTRACT

Colocolic fistulas are usually a complication of an inflammatory or neoplastic process. Development of these abnormal bowel communications may lead to bacterial overgrowth. We report on a 71-year-old man with a one-year history of recurrent abdominal distension and irregular bowel habits. Abdominal X-rays and computed tomography showed multiple air-fluid levels and loops of distended bowel without evidence of mechanical obstruction or diverticulitis. Colonoscopy showed a fistulous tract between the sigmoid colon and cecum. Results of a lactulose breath test showed high fasting breath CH4 levels, which were thought to be the result of intestinal bacterial overgrowth. The patient was diagnosed with a colonic pseudo-obstruction associated with bacterial overgrowth due to a sigmoidocecal fistula. We recommended surgical correction of the sigmoidocecal fistula; however, the patient requested medical treatment. After antibiotic therapy, the patient still had mild symptoms but no acute exacerbations.


Subject(s)
Aged , Anti-Bacterial Agents/therapeutic use , Breath Tests , Colonic Pseudo-Obstruction/diagnosis , Colonoscopy , Humans , Intestinal Fistula/diagnosis , Male , Methane/chemistry , Tomography, X-Ray Computed
15.
Article in English | WPRIM | ID: wpr-60729

ABSTRACT

Colonic pseudo-obstruction (CPO) is defined as marked colonic distension in the absence of mechanical obstruction. We aimed to investigate the clinical characteristics of CPO and the factors associated with the response to medical treatment by using a multicenter database in Korea. CPO was diagnosed as colonic dilatation without mechanical obstruction by using radiologic and/or endoscopic examinations. Acute CPO occurring in the postoperative period in surgical patients or as a response to an acute illness was excluded. CPO cases were identified in 15 tertiary referral hospitals between 2000 and 2011. The patients' data were retrospectively reviewed and analyzed. In total, 104 patients (53 men; mean age at diagnosis, 47 yr) were identified. Seventy-seven of 104 patients (74%) showed a transition zone on abdominal computed tomography. Sixty of 104 patients (58%) showed poor responses to medical treatment and underwent surgery at the mean follow-up of 7.4 months (0.5-61 months). Younger age at the time of diagnosis, abdominal distension as a chief complaint, and greater cecal diameter were independently associated with the poor responses to medical treatment. These may be risk factors for a poor response to medical treatment.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Colon/pathology , Colonic Pseudo-Obstruction/diagnosis , Constipation/diagnosis , Dilatation, Pathologic , Female , Humans , Male , Middle Aged , Republic of Korea , Retrospective Studies , Sagittal Abdominal Diameter , Tomography, X-Ray Computed , Treatment Outcome , Young Adult
17.
Korean Journal of Medicine ; : 591-596, 2013.
Article in Korean | WPRIM | ID: wpr-193302

ABSTRACT

Acute colonic pseudo-obstruction (ACPO) or Ogilvie's syndrome is a rare disorder of intestinal motility characterized by massive colonic dilatation without mechanical obstruction. We report a case of ACPO combined with rhabdomyolysis induced by severe hypokalemia. A 78-year-old male with a 10-year history of hypertension presented with abdominal pain and distension for 2 days. The laboratory findings showed hypokalemia with markedly elevated serum creatine phosphokinase and myoglobin levels. A plain abdominal x-ray revealed a markedly distended ascending and transverse colon with a cut-off sign at the descending colon. Mechanical obstruction of the intestine was excluded by computed tomography and colonoscopy. He was initially treated with supportive therapy, including insertion of a rectal tube and intravenous fluids with potassium replacement. However, the ACPO persisted, and neostigmine was administered in two separate 2.0-mg intravenous injections, 24 hours apart. Subsequently, the abdominal pain and colonic distension were relieved.


Subject(s)
Abdominal Pain , Colon , Colon, Descending , Colon, Transverse , Colonic Pseudo-Obstruction , Colonoscopy , Creatine Kinase , Dilatation , Gastrointestinal Motility , Humans , Hypertension , Hypokalemia , Injections, Intravenous , Intestines , Male , Myoglobin , Neostigmine , Potassium , Rhabdomyolysis
18.
Blood Research ; : 145-148, 2013.
Article in English | WPRIM | ID: wpr-74584

ABSTRACT

Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome, is a rare clinical syndrome of massive large bowel dilatation without mechanical obstruction, which may cause significant morbidity and mortality. Treatment focuses on decompressing a severely dilated colon. The proposed theory that this severe ileus results from an imbalance in the autonomous regulation of colonic movement supports the rationale for using neostigmine, a reversible acetylcholinesterase inhibitor, in patients who failed conservative care. Although gastrointestinal complications are frequent following allogeneic stem cell transplantation (SCT), the incidence of ACPO in a transplant setting is unknown and, if not vigilant, this adynamic ileus can be underestimated. We describe the case of a patient with myelodysplastic syndrome undergoing non-myeloablative allogeneic SCT from a partially human leukocyte antigen-mismatched sibling donor, and whose clinical course was complicated by ACPO in the early post-engraftment period. The ileus was not associated with gut graft-versus-host disease or infectious colitis. After 3 days of conservative care, intravenous neostigmine (2 mg/day) was administered for 3 consecutive days. Symptoms and radiologic findings began to improve 72 hours after the initial injection of neostigmine, and complete response without any associated complications was achieved within a week. Thus, neostigmine can be a safe medical therapy with successful outcome for patients who develop ACPO following allogeneic SCT.


Subject(s)
Acetylcholinesterase , Colitis , Colon , Colonic Pseudo-Obstruction , Dilatation , Graft vs Host Disease , Humans , Ileus , Incidence , Leukocytes , Myelodysplastic Syndromes , Neostigmine , Siblings , Stem Cell Transplantation , Stem Cells , Tissue Donors , Transplants
19.
Article in English | IMSEAR | ID: sea-143638

ABSTRACT

Torsion of appendices ep loicae is an uncommon differential diagnosis of a patient presenting with acute abdominal pain and its presentation as a Ogilvie’s syndrome or colonic ileus is even rare.The diagnosis requires a keen suspicion on the part of the attending surgeon. Preoperative computrized tomography ( CT) may help in the diagnosis but the final diagnosis is established only on the operating table . Adding this pathology to the existing list of the causes of colonic ileus /Ogilvies syndrome may give us a good insight into the understanding of the condition&improvise our management. This is a case report of 60 year old lady who was referred to us with nonspecific abdominal pain , distention of abdomen and vomiting from orthopaedics department , where she was being planned for surgery for intertrochanteric fracture femur. All our investigations were equivocal and suggested a Ogilvie’s syndrome like picture .Atrial of neostigmine therapy was also given after excluding physical obstruction and the patient did not respond and the patient was operated upon and intraoperative finding of torsed epiploic appendage was found as the cause of her symptoms. The patient made a good post operative recovery following surgical excision of torsed epiploic appendages. This case should give us another dimension of thought in the management of such cases and help improvise our management.


Subject(s)
Adult , Appendix/injuries , Appendix/surgery , Colonic Pseudo-Obstruction/surgery , Female , Humans , Torsion, Mechanical
20.
Intestinal Research ; : 379-382, 2012.
Article in English | WPRIM | ID: wpr-154831

ABSTRACT

Acute colonic pseudo-obstruction (Ogilvie syndrome) associated with herpes zoster is extremely rare, and few cases have been reported. An 81-year-old woman diagnosed with herpes zoster was referred for accompanying colonic ileus. The diameter of the cecum was 7 cm and a computed tomographic scan showed no definite obstructive cause. Because the patient showed minimal improvement with conservative treatment, endoscopic colonic decompression was performed successfully. Previous studies revealed that the treatment of Ogilvie syndrome associated with herpes zoster does not differ from that of other conditions, and the role of the varicella-zoster virus in this syndrome is unclear. Here, we present the first case of Ogilvie syndrome associated with herpes zoster in Korea, which was improved by endoscopic colonic decompression.


Subject(s)
Aged, 80 and over , Cecum , Colon , Colonic Pseudo-Obstruction , Decompression , Female , Herpes Zoster , Herpesvirus 3, Human , Humans , Ileus , Korea
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