colonic pseudo obstruction


Summary: Functional obstruction of the COLON leading to MEGACOLON in the absence of obvious COLONIC DISEASES or mechanical obstruction. When this condition is acquired, acute, and coexisting with another medical condition (trauma, surgery, serious injuries or illness, or medication), it is called Ogilvie's syndrome.

Top Publications

  1. Lutz P, Maring D, Tschampa H, Sauerbruch T. [A 25-year-old patient with colonic pseudo-obstruction, hyponatremia, hypertension, and diffuse pain]. Med Klin (Munich). 2010;105:267-72 pubmed publisher
    ..This delay leads to a high risk of aggravating the disease by prescribing porphyrinogenic drugs. ..
  2. Martin M, Steele S, Mullenix P, Noel J, Weichmann D, Azarow K. A pilot study using total colonic manometry in the surgical evaluation of pediatric functional colonic obstruction. J Pediatr Surg. 2004;39:352-9; discussion 352-9 pubmed
    ..TCM can be valuable in deciding the need for and timing of diversion, the extent of resection required, and the suitability of the patient for restoring bowel continuity in refractory functional obstruction. ..
  3. Khosla A, Ponsky T. Acute colonic pseudoobstruction in a child with sickle cell disease treated with neostigmine. J Pediatr Surg. 2008;43:2281-4 pubmed publisher
    ..Early recognition of this phenomenon is important as it alters patient management, can be treated medically, and may avoid unnecessary surgical intervention...
  4. Gentric A, Le Deun P. Acute colonic pseudoobstruction: an unusual presentation of thyrotoxic periodic paralysis. J Am Geriatr Soc. 2005;53:2237-8 pubmed
  5. von Gunten C, Muir J. Fast facts and concepts #45. Medical management of bowel obstruction. J Palliat Med. 2002;5:739-40 pubmed
  6. Khajehnoori M, Nagra S. Acute colonic pseudo-obstruction (Ogilvie's syndrome) with caecal perforation after caesarean section. J Surg Case Rep. 2016;2016: pubmed publisher
    ..This is a case report of bowel perforation following caesarean section leading to urgent laparotomy. ..
  7. Robinson A, Quigley J, Banks A, Farmer M. Ogilvie's syndrome treated with an emergency laparotomy, right hemicolectomy and end ileostomy. BMJ Case Rep. 2017;2017: pubmed publisher
    ..The case emphasises the importance of early recognition and timely intervention in the management of this rare yet potentially fatal cause of megacolon...
  8. Reignier J, Boisramé Helms J, Brisard L, Lascarrou J, Ait Hssain A, Anguel N, et al. Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). Lancet. 2018;391:133-143 pubmed publisher
    ..La Roche-sur-Yon Departmental Hospital and French Ministry of Health. ..
  9. Irabor D, Ladipo J, Ogunsanya W, Akra G, Oladoyin O, Aimakhu C. Ogilvie's syndrome (colonic pseudo-obstruction) occurring in an 18-year-old Nigerian female. West Afr J Med. 2001;20:75-7 pubmed
    ..Ogilvie's syndrome which is colonic obstruction without an identifiable distal mechanical cause is reported in an 18 year old female Nigerian. A high index of awareness is required to diagnose this condition. ..

More Information


  1. Aslan S, Bilge F, Aydinli B, Ocak T, Uzkeser M, Erdem A, et al. Amitraz: an unusual aetiology of Ogilvie's syndrome. Hum Exp Toxicol. 2005;24:481-3 pubmed
    ..On the fifth day, abdominal pain and distension were decreased, and stool passage began. She had a complete clinical and laboratory improvement, which warranted her discharge on the seventh day of admission. ..
  2. Mousa H, Hyman P, Cocjin J, Flores A, Di Lorenzo C. Long-term outcome of congenital intestinal pseudoobstruction. Dig Dis Sci. 2002;47:2298-305 pubmed
  3. Murakami S, Okushiba S, Ohno K, Ito K, Satou K, Sugiura H, et al. Malignant pheochromocytoma associated with pseudo-obstruction of the colon. J Gastroenterol. 2003;38:175-80 pubmed
    ..Laxatives and enemas were not effective in relieving his symptoms. We subsequently performed an ileostomy, after which the patient had good bowel movement and was able to resume oral food intake. ..
  4. Cowlam S, Watson C, Elltringham M, Bain I, Barrett P, Green S, et al. Percutaneous endoscopic colostomy of the left side of the colon. Gastrointest Endosc. 2007;65:1007-14 pubmed
    ..Fatal fecal peritonitis occurred in 2 patients. Indiscriminate use of a PEC in the left side of the colon is not recommended. A PEC should only be considered in carefully selected cases. ..
  5. Longacre A, Aslanian H. Acute colonic pseudo-obstruction after colonoscopy in a young woman on narcotics. J Clin Gastroenterol. 2006;40:225 pubmed
  6. Busch F, Hamdorf J, Carroll C, Magann E, Morrison J. Acute colonic pseudo-obstruction following cesarean delivery. J Miss State Med Assoc. 2004;45:323-6 pubmed
    ..Although acute colonic pseudo-obstruction is uncommon, it is important that obstetric practitioners recognize this clinical entity as the potentially fatal consequences of cecal perforation can be prevented by tube cecostomy. ..
  7. Ermisch J, Schauer K. [Transanal decompression procedure in acute pseudo-obstruction of the colon]. Zentralbl Chir. 1991;116:575-9 pubmed
    ..However this does not apply to advanced cases or when there is threat of a colon perforation. As a possible alternative to a colostomy for transanal aseptic decompression a new intestinal tube is introduced. ..
  8. Hyklová L, Poloucek P. [Pseudoobstruction of the colon following the thoracic surgery]. Rozhl Chir. 2004;83:347-9 pubmed
    ..On the basis of authors' own experiences certain therapeutic moments are discussed. Although conservative approach is preferred the surgery remains elementary therapeutic procedure. ..
  9. Jiang D, Zhang Y, Jiang Z, Li Z. Intravenous low-dose erythromycin could be an efficacious treatment for acute colonic pseudo-obstrcution (ACPO)/ Ogilvie's syndrome in children. Med Hypotheses. 2008;70:706 pubmed
  10. Benlloch S, Pérez Aguilar F, Ponce J, Berenguer J. [Chronic colonic pseudo-obstruction secondary to neuroleptics]. Gastroenterol Hepatol. 2001;24:500-2 pubmed
    ..Cisapride (20 mg/8 h) produced a slight improvement in symptoms but colonic dilatation was permanent. ..
  11. Athreya S, Moss J, Urquhart G, Edwards R, Downie A, Poon F. Colorectal stenting for colonic obstruction: the indications, complications, effectiveness and outcome--5 year review. Eur J Radiol. 2006;60:91-4 pubmed
    ..Survival ranged from 14 days to 2 years. Colorectal stenting when technically successful is an effective procedure for both preoperative and palliative decompression of colonic obstruction. ..
  12. Sule A, Uba A, Kidmas A. Acute colonic pseudo-obstruction (Ogilvie's syndrome). A case presentation and review of literature. Niger J Med. 2002;11:56-9 pubmed
    ..In this report, a patient with acute colonic pseudo-obstruction managed surgically is presented. The pathogenesis and surgical management of this condition is also reviewed. ..
  13. Nguyen H, Cobbs E. Chronic colonic pseudo-obstruction associated with recurrent congestive heart failure. J Am Geriatr Soc. 2005;53:171-2 pubmed
  14. Molina J, Serrano C, De Teresa L. [Hypocalcemia and hyperphosphatemia secondary to oral sodium phosphate in a female patient with colonic pseudo-obstruction and vitamin D deficiency]. An Med Interna. 2002;19:267-8 pubmed
  15. Petrisor B, Petruccelli D, Winemaker M, de Beer J. Acute colonic pseudo-obstruction after elective total joint arthroplasty. J Arthroplasty. 2001;16:1043-7 pubmed
    ..The remaining cases of ACPO resolved with nonsurgical treatment. In all cases, there was a prolonged length of hospitalization (mean, 13.2 days) compared with all other arthroplasties performed at our institution (mean, 7.5 days). ..
  16. Shukla M, Barros R, Majjiga V, Tripathy A. Acute colonic pseudo-obstruction in a pediatric patient. J Pediatr Gastroenterol Nutr. 2007;45:600-2 pubmed
  17. Pokorny H, Plöchl W, Soliman T, Herneth A, Scharitzer M, Pokieser P, et al. Acute colonic pseudo-obstruction (Ogilvie's-syndrome) and pneumatosis intestinalis in a kidney recipient patient. Wien Klin Wochenschr. 2003;115:732-5 pubmed
    ..Colonoscopic decompression can achieve reversal of colonic dilatation in most cases, but in some patients prophylactic laparotomy is indicated for prevention of the catastrophic consequences of perforation. ..
  18. Cho F, Liu C, Li J, Chen S, Yu K. Adynamic ileus and acute colonic pseudo-obstruction occurring after cesarean section in patients with massive peripartum hemorrhage. J Chin Med Assoc. 2009;72:657-62 pubmed publisher
    ..Here, we examine how to differentiate mechanical bowel obstruction from adynamic ileus and look at how to prevent the occurrence of adynamic ileus while minimizing its severity and shortening its clinical course. ..
  19. Kumar S, Gilliland R. Profuse per rectal bleeding due to erosion of the inferior epigastric artery following a catheter tube caecostomy. Ulster Med J. 2007;76:41 pubmed
  20. Southwell B, King S, Hutson J. Chronic constipation in children: organic disorders are a major cause. J Paediatr Child Health. 2005;41:1-15 pubmed
  21. Hughes A, Ferguson I, Rankin E, Kane K. Polymyositis as a cause of total gut failure. Ann Rheum Dis. 2002;61:305-6 pubmed
    ..The patient's polymyositis is now fully controlled biochemically, but her gastrointestinal symptoms persist. ..
  22. Davis M, Langan J, Mylniczenko N, Benson K, Lamberski N, Ramer J. Colonic obstruction in three captive reticulated giraffe (Giraffa camelopardalis reticulata). J Zoo Wildl Med. 2009;40:181-8 pubmed
    ..Abdominal exploratory surgery will likely be necessary for diagnosis and treatment. Based on a small number of cases, gastrointestinal obstruction has a poor prognosis in giraffe. ..
  23. Mathur S, Lakhani O, Hathila V, Duttaroy D, Vohra A, Chauhan H. Acute colonic pseudo-obstruction (Ogilvie syndrome) with Chilaiditi syndrome. Med J Aust. 2008;189:42 pubmed
  24. Sundaram S, Brown R, Zhang P. Unusual type of colonic neuromuscular disorder with extensive vacuolization. Ann Clin Lab Sci. 2008;38:143-8 pubmed
    ..This disorder is most likely a sporadic visceral neuropathy, secondarily affecting muscular function, that causes colonic pseudo-obstruction. ..
  25. Cebola M, Eddy E, Davis S, Chin Lenn L. Acute Colonic Pseudo-Obstruction (Ogilvie's Syndrome) Following Total Laparoscopic Hysterectomy. J Minim Invasive Gynecol. 2015;22:1307-10 pubmed publisher
    ..Cecal resection, colonic decompression, and end ileostomy formation were performed. A brief review of the current literature is presented with respect to the case report. ..
  26. Saunders M, Kimmey M. Colonic pseudo-obstruction: the dilated colon in the ICU. Semin Gastrointest Dis. 2003;14:20-7 pubmed
    ..Appropriate management includes supportive therapy and selective use of neostigmine and colonoscopy for decompression. Early recognition and management are critical in minimizing complications. ..
  27. Lankarani Fard A, Castle S. Postoperative delirium and Ogilvie's syndrome resolving with neostigmine. J Am Geriatr Soc. 2006;54:1016-7 pubmed
  28. Gurleyik G, Kotan C, Dulundu E, Ozturk E, Sönmez R, Saglam A. [Clinical differences between surgically treated patients with large bowel obstruction in the cities of Van and Istanbul]. Ulus Travma Derg. 2002;8:38-42 pubmed
    ..A considerable mortality arises in surgically treated patients with colonic obstruction. Postoperative mortality was significantly elevated in cases of obstruction complicated by strangulation, necrosis, and perforation. ..
  29. Bouchoucha M, Devroede G, Faye A, Le Toumelin P, Arhan P, Arsac M. Colonic response to food in constipation. Int J Colorectal Dis. 2006;21:826-33 pubmed
    ..Abnormal colonic response to food is frequently found in constipated patients, with different patterns according to the type of constipation. ..
  30. Hartman V, Van Hee R. Acute colonic pseudo-obstruction in vascular patients (Ogilvie syndrome). Acta Chir Belg. 2009;109:760-2 pubmed
    ..In both patients, right hemicolectomy and postoperative medical treatment resulted in complete recovery. ..
  31. Roberts C. Ogilvie's syndrome after cesarean delivery. J Obstet Gynecol Neonatal Nurs. 2000;29:239-46 pubmed
    ..Nursing assessment of the gastrointestinal system in the postsurgical patient is reviewed using a case report of a patient who developed Ogilvie's syndrome after a cesarean delivery. ..
  32. Ernst R, Müller R, Hess T. [Ogilvie's syndrome (acute idiopathic colonic pseudo-obstruction) after Caesarean section]. Gynakol Geburtshilfliche Rundsch. 2007;47:236-9 pubmed
    ..After 3 weeks of hospitalization, the patient was discharged in good general health. ..
  33. Choi J, Lim J, Kim H, Choi J, Kim M, Kim N, et al. Colonic pseudoobstruction: CT findings. AJR Am J Roentgenol. 2008;190:1521-6 pubmed publisher
    ..Pathologic examination reveals that intramural ganglion damage has a high tendency to occur in cases of chronic colonic pseudoobstruction. ..
  34. Uno Y. Introducer method of percutaneous endoscopic cecostomy and antegrade continence enema by use of the Chait Trapdoor cecostomy catheter in patients with adult neurogenic bowel. Gastrointest Endosc. 2006;63:666-73 pubmed
    ..Retrospective, single-institution. PEC with IM is a safe and useful method. CTCC is advantageous on a long-term basis for ACE. ..
  35. Saunders M. Acute colonic pseudo-obstruction. Best Pract Res Clin Gastroenterol. 2007;21:671-87 pubmed
    ..Appropriate management includes supportive therapy and selective use of neostigmine and colonoscopy for decompression. Early recognition and management are critical in minimising complications. ..
  36. Pui J, Furth E, Minda J, Montone K. Demonstration of varicella-zoster virus infection in the muscularis propria and myenteric plexi of the colon in an HIV-positive patient with herpes zoster and small bowel pseudo-obstruction (Ogilvie's syndrome). Am J Gastroenterol. 2001;96:1627-30 pubmed
    ..Viral particles consistent with Herpesviridae were shown to be present ultrastructurally. We postulate that the viral infection in the neuronal plexi and muscularis propria caused muscle injury leading to pseudo-obstruction. ..
  37. Gmora S, Poenaru D, Tsai E. Neostigmine for the treatment of pediatric acute colonic pseudo-obstruction. J Pediatr Surg. 2002;37:E28 pubmed
    ..To date, however, this literature has focused exclusively on the adult population. The authors present the first reported case of the successful administration of neostigmine to treat acute colonic pseudo-obstruction in a child. ..
  38. Dervenis C, Delis S, Filippou D, Avgerinos C. Intestinal obstruction and perforation--the role of the surgeon. Dig Dis. 2003;21:68-76 pubmed
    ..Mechanisms of obstruction and perforation, methods of diagnosis as well as prevention and treatment of the disease were reviewed. ..
  39. Rendón Medina M. [Dysmorphic neonatal syndrome and Ogilvie syndrome]. Cir Cir. 2017;85:148-153 pubmed publisher
    ..Conservative management in this disease is the initial approach. Interventions should be reserved for when conservative treatment fails. ..
  40. Mongardini M, Schillaci F, Cola A, Fanello G, Benedetti F, Maturo A, et al. [Adhesion ileus in patient with previous diagnosis of Ogilvie's syndrome]. G Chir. 2005;26:318-20 pubmed
    ..The differential diagnosis between mechanical ileus and pseudoobstruction for neuro-mechanics dissociation (Ogilvie's syndrome) is difficult, particularly in patients with neurodegenerative diseases. ..
  41. Kaszaki J, Palásthy Z, Erczes D, Racz A, Torday C, Varga G, et al. Kynurenic acid inhibits intestinal hypermotility and xanthine oxidase activity during experimental colon obstruction in dogs. Neurogastroenterol Motil. 2008;20:53-62 pubmed
    ..In conclusion, KynA antagonizes the obstruction-induced motility responses and XOR activation in the colon. Inhibition of enteric NMDA receptors may provide an option to influence intestinal hypermotility and inflammatory changes. ..
  42. Haack H. [Intestinal pseudo-obstruction]. Ther Umsch. 2007;64:217-20 pubmed
    ..Treatment of CIPO depends on the severity of the disease and often needs a multidisciplinary approach. ..
  43. Knox Macaulay H, Ayyaril M, Nusrat N, Daar A. Colonic pseudo-obstruction in sickle cell disease. South Med J. 2003;96:93-5 pubmed
  44. Kim T, Lee J, Kim M, Park Y, Lee D, Chung N, et al. Acute colonic pseudo-obstruction in postchemotherapy complication of brain tumor treated with neostigmine. J Pediatr Hematol Oncol. 2007;29:420-2 pubmed
    ..We report a 9-year-old boy with acute colonic pseudo-obstruction caused by chemotherapy for brain tumor who did not respond to initial supportive therapy, but who was successfully treated with neostigmine...
  45. Karatosun V, Karadam B. [A case of acute colonic pseudo-obstruction following total hip arthroplasty]. Acta Orthop Traumatol Turc. 2005;39:263-5 pubmed
    ..This syndrome should be borne in mind following major orthopedic interventions and be diagnosed and treated without delay. ..
  46. Grassi R, Cappabianca S, Porto A, Sacco M, Montemarano E, Quarantelli M, et al. Ogilvie's syndrome (acute colonic pseudo-obstruction): review of the literature and report of 6 additional cases. Radiol Med. 2005;109:370-5 pubmed
    ..In three of our patients, conservative therapy alone was able to restore normal conditions within five days; two patients required decompressive colonoscopy, and one patient died from cardio-circulatory arrest after 48 hours. ..
  47. Vega Basulto S, Mosquera Betancourt G, Varela Hernández A. [Ogilvie's syndrome. A report of 3 cases]. Neurocirugia (Astur). 2002;13:229-32 pubmed
    ..Other lumbar disc surgery complications such as gastrointestinal perforation, urethral injury or intra-abdominal vessels damage were excluded. Conservative treatment including parenteral neostigmine was always sucessful. ..
  48. Tamhane U, Allen S, Maddens M. Pseudo-obstruction due to foreign body: importance of good physical examination. J Am Geriatr Soc. 2008;56:952-3 pubmed publisher
  49. Durai R. Colonic pseudo-obstruction. Singapore Med J. 2009;50:237-44 pubmed
    ..In spite of available medical and surgical interventions, the outcome remains poor. ..
  50. Farinella E, Nazzaro C, Rossetti B, Giuliani D, Giustozzi G, Sciannameo F. [Chilaiditi's syndrome: a rare cause of abdominal pain in the differential diagnosis of the abdominal perforation. Case report]. G Chir. 2006;27:417-21 pubmed
    ..Although the Chilaiditi's syndrome is rare, it must be considerated in differential diagnosis of perforative abdominal syndrome, when there are doubts about the subdiaphragmatic air in abdominal film. ..
  51. Koornstra J, Klaver N, ter Maaten J, Limburg A, van der Jagt E, van der Werf T. [Neostigmine treatment of acute pseudo-obstruction of colon (Ogilvie syndrome)]. Ned Tijdschr Geneeskd. 2001;145:586-9 pubmed
    ..Early recognition of the condition and prompt neostigmine treatment if conservative measures fail is important to reduce the risk of bowel perforation. ..
  52. Cappell M, Friedel D. The role of sigmoidoscopy and colonoscopy in the diagnosis and management of lower gastrointestinal disorders: endoscopic findings, therapy, and complications. Med Clin North Am. 2002;86:1253-88 pubmed
    ..Colonoscopy is becoming more important clinically because of more widespread use of screening colonoscopy for colon cancer, application of therapeutic colonoscopy, and exciting new technical improvements. ..
  53. Hashimoto Y, Motoyoshi S, Maruyama H, Sakakida M, Yano T, Yamaguchi K, et al. The treatment of pheochromocytoma associated with pseudo-obstruction and perforation of the colon, hepatic failure, and DIC. Jpn J Med. 1990;29:341-6 pubmed
    ..The significant role of catecholamines in causing these symptoms is discussed, and the management of this relatively rare complication is reviewed...