An update on acute colonic pseudo-obstruction (Ogilvie's Syndrome)

The syndrome of acute colonic pseudo-obstruction was first described by Ogilvie in 1948 (1). Ogilvie's syn- drome is characterized by an acute massive dilation of the caecum and the right colon, in the absence of a dis- tal mechanical obstruction. Since then, it has been recognized as a complication occurring in patients who underwent surgery and in patients with serious medical conditions. Ogilvie's syndrome is associated with an underlying disease in 95 percent of patients. Most often, the dilatation of the right colon is associated with a simultaneous pseudo-obstruction of the small intestine, which is less severe (2). Ogilvie's syndrome is a relatively rare condition, but since the original description more then 500 cases were described in literature. It has been estimated that this complication occurs in approximately 0.1% of the patients undergoing surgery, in approximately 0.05% of the patients admitted for trauma and in 0.3% of critical- ly ill patients with burns (2,3). Elderly patients have a higher risk of developing acute colonic pseudoobstruc- tion (4).