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  • Meeting abstract
  • Open Access

O'Gilvie's Syndrome (colonic pseudo-obstruction) in the intensive care unit

  • 1,
  • 1,
  • 1 and
  • 1
Critical Care19982 (Suppl 1) :P145

https://doi.org/10.1186/cc274

  • Published:

Keywords

  • Ileus
  • Parenteral Nutrition
  • Total Parenteral Nutrition
  • Cisapride
  • Tube Placement

Background

O'Gilvie's syndrome (colonic pseudo-obstruction) is a gastrointestinal motility disorder affecting the whole bowel but involving mainly the colon. It produces an acute massive dilation of the large bowel without organic obstruction. The cause of the disease is not known but it seems to involve some autonomic neurologic disorder affecting the myenteric plexus. For unknown reasons it affects selectively elderly, COPD patients with critical diseases (sepsis, polytrauma, vascular disease, etc.). The mainstay of the differential diagnosis is to exclude any cause of mechanical ileus. The treatment of the syndrome is mainly supportive including administration of fluids and electrolytes, total parenteral nutrition, and cisapride. If after these measures pseudo-obstruction still persists, colonoscopic decompression is required. An endoscopic placement of a transanal large bore nasogastric tube in the transversus colon is suggested. Continuous lavage of the colon through the tube could be useful. If after these measures the colon is still dilated, surgery with cecostomy is indicated.

Results

In the next table we report our experience in six cases of O'Gilvie syndrome patients during the years 1996–1997.

Conclusion

In our experience O'Gilvie's syndrome is much more common than reported. Medical treatment including cisapride is valuable but in severe cases colonoscopic decompression with transanally NG tube placement with continous lavage is required. In some cases a surgical decompressive cecostomy may be necessary.

Table

Age

Sex

Diagnostic

Treatment

Outcome

77

Male

COPD/Pneumonia

Cecostomy

Alive

76

Male

COPD/Pyelonephritis

Colonic NG Tube

Alive

72

Male

COPD

Cecostomy

Alive

68

Male

COPD/Pneumonia

Colonic NG Tube

Alive

67

Male

COPD

Colonic NG tube+lavage

Alive

65

Male

COPD

Colonic NG tube+lavage

Alive

Authors’ Affiliations

(1)
Intensive Care Medicine Department, Hospital General de Manresa, La Culla S/N, O8240 Manresa (Barcelona), Spain

Copyright

© Current Science Ltd 1998

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