Unraveling the Enigma of Ogilvie Syndrome’s Acute Colonic Pseudo-Obstruction Complicated with Multiple Comorbidities: A Case Report

Ogilvie Syndrome’s Multiple Comorbidities

Abstract

Ogilvie syndrome, an uncommon condition characterized by acute colonic pseudo-obstruction. This presents unique diagnostic and management challenges. It is particularly difficult because it usually occurs in patients with a complicated medical history and is associated with variable outcomes.
A 61-year-old gentleman with cervical fracture-induced paraplegia, gastritis, and hemorrhoids presented with a distinct manifestation of Ogilvie syndrome. The patient presented with symptoms of abdominal distension, fever, shortness of breath, and a 2-week history of no bowel movements. The presence of comorbidities and the common occurrence of constipation complicate the diagnostic process. Radiological imaging revealed extensive colonic dilation from the cecum to rectosigmoid junction. The patient’s management included a conservative approach involving intravenous fluids, intermittent aspiration, antibiotic therapy, and vigilant monitoring. As a result, the patient displayed improved clinical parameters, reduced abdominal distension, and gradual return of bowel function. However, the patient’s intricate medical history continues to pose ongoing challenges, necessitating long-term follow-up. Previous cases of Ogilvie syndrome were retrieved from PubMed to characterize the clinicopathological features and identify prognostic factors of Ogilvie syndrome.
This case highlights clinical acumen in distinguishing Ogilvie syndrome, which presents symptoms of acute emergency abdomen and intestinal obstruction, as opposed to constipation with chronic and non-specific abdominal discomfort.