Ogilvie`s Syndrome: Presentation of 15 Cases

Background: Ogilvie's syndrome is characterized by acute, massive colonic dilatation, without any mechanical obstruction. Methods: The records of 15 patients with Ogilvie's syndrome were retrospectively reviewed with respect to gender, age, associated problems, symptom duration, symptoms, signs, treatment, morbidity, mortality, and recurrence. Results: Mean age of the patients (8 male, 7 female) was 49.9 years (range: 32-76 years). Among them, 5 had medical problems, while 4 patients had had abdominal surgery, and 2 patients had burns. Mean symptom duration was 2.9 days (range: 1-7 days). The most common symptoms were abdominal pain and distention, while the most common signs were abdominal tenderness and distention. Mean cecal diameter was 10.0 cm (range: 7-13 cm) in plain abdominal X-ray films. The initial treatment was conservative in all patients; 5 were treated with intravenous neostigmine and complete resolution was achieved in 4 of them (80%). Flexible colonoscopic decompression was performed in 9 patients, with placement of a colonic tube; a success rate of 88.9% and a recurrence rate of 12.5% were noted. Tube cecostomy procedures were performed on 4 patients. No major complications were encountered in this series, but one patient with burns died (6.7%). Conclusions: The initial treatment of Ogilvie's syndrome is conservative, and neostigmine treatment is generally successful. Decompression colonoscopy can be performed safely and successfully. Surgical treatment is performed when colonoscopy is unsuccessful, or when cecal ischemia, necrosis, or perforation is suspected.