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Ogilvie Syndrome

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What is Ogilvie syndrome?

This is a rare, acquired intestinal disorder in which your colon dilates radically and appears to be obstructed but there is no physical obstruction there. It is a disorder that is usually seen in people who are ill and hospitalized for other medical conditions. Because it comes on rapidly and acts like an obstruction it is also known as acute colonic pseudo-obstruction. It can also be associated with a high mortality rate as much as thirty percent but if it is managed correctly it is usually not fatal. It was first described in medical literature in 1948 by Sir William Ogilvie, a British surgeon. It affects men and women equally and can occur at any age but often occurs after the age of sixty.


Symptoms

When a person has this intestinal disorder they can develop:

  • Swelling, or abdominal distention, which can develop within a twenty-four hour period or over several days and can be massive
  • Abdominal pain
  • Bloating
  • Fever
  • Marked abdominal tenderness
  • An abnormal increase in their white blood cells

They may also have constipation, nausea, and vomiting. What actual symptoms a person has will vary from person to person.

Risks

There are several things that are known to increase the risk of a person developing Ogilvie syndrome such as:

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  • Surgery, especially after total joint replacement or coronary artery bypass surgery
  • Neurological problems
  • Certain medications

Diagnosis

Before they can diagnosis Ogilvie syndrome the physician must rule out other potential issues like intestinal perforation or having an actual obstruction. They will use an x-ray to check for the dilation of the colon.

Treatment

To treat Ogilvie syndrome the physician will need to work on managing the underlying cause along with providing supportive care. Once Ogilvie syndrome has been diagnosed immediate care will usually involve reducing the oral intake of water and food. They will use intravenous delivery of fluids in order to encourage the person to move express gas and balance their electrolytes. In some cases they may have to insert a nasogastric tube, which is a tube that goes in the person’s nose, past their throat and down into their stomach. It is also used to feed and administer medications to the person.

If the person does not seem to be improving within a couple of days or appears to be getting worse rapidly they may have to have surgery but this mode of treatment can be risky especially if the person is already sick. Surgery could also increase the risk of complications during the procedure so the surgical team monitors the person through the procedure for any signs of distress.

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