Ogilvie syndrome and its new treatment strategies

Abstract

Acute colonic pseudo-obstruction, known as Ogilvie's syndrome, refers to a massive dilatation of the colon (especially the right colon) without being associated with an underlying mechanical obstruction or another organic cause. The pathophysiological mechanisms of this disease are not well defined, however, it is believed that there is some type of functional alteration in the enteric nervous system. Its incidence is low and it occurs more frequently in patients who associate some type of comorbidity, hospitalized or institutionalized people, as well as those who have required recent surgical interventions. Clinical manifestations include abdominal bloating and pain, nausea with vomiting, and constipation. Its diagnosis is one of exclusion and requires ruling out structural causes through clinical and radiological tests. Intestinal perforation and ischemia are the most serious complications. Its management is broad and varies from observational and conservative behavior to surgical intervention. The success rate is 80% with recurrences in 6-14%, 20% of which will require surgery. The patient's prognosis and survival depend on timely recognition, diagnosis and therapeutic management.