Ogilvie's Syndrome Extended to the Rectum: Two Case Reports

Yusuke Nishizawa, Hajime Morohashi, Sakae Oota, Motoi Koyama, Akihiko Murata and Mutsuo Sasaki

Department of Gastroenterological Surgery, University of Hirosaki

We report two cases of Ogilvie's syndrome involving dilated intestine extending to the rectum. Case 1: A 75-year-old woman hospitalized for a bronchial asthma attack was found to have severe abdominal distension. Case 2: A 70-year-old woman admitted for abdominal pain and distension was found in plain abdominal X-ray to have distension of the sigmoid colon extending to the rectum. Decompression by colonofiber and transanal ileus tube did not relieve abdominal distension and colonofiber showed no organic lesion, suggesting limits to conservative therapy and necessitating surgery. In case 1, sigmoid colon resection of the main lesion resulted in relapse into dilation of the oral colon. In case 2, abdomino anal resection of the rectum and sigmoid colon was done to completely resect the dilated intestine. The post operative course was uneventful. While conservative therapy such as decompression with colonofiber should be the first chice for treating Ogilvie's syndrome, many cases became refractory enough to require surgery. We reviewed 75 cases of Ogilvie's syndrome in the literature.

Key words
Ogilvie's syndrome, acute colonic pseudoobstruction (ACPO), functional stenosis

Reprint requests
Yusuke Nishizawa Department of Gastroenterological Surgery, University of Hirosaki
5 Zaihucho, Hirosaki, 036-8562 JAPAN

Accepted
March 26, 2008

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