Ogilvie’s Syndrome Post Elective Caesarean Section

https://doi.org/10.22146/jkr.85194

Eugenius Phyowai Ganap(1*), Annisa Fitriani(2), Andhyta Ratih Wulandari(3)

(1) Departemen Obstetri dan Ginekologi, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan (FKKMK) UGM
(2) Departemen Obgin FKKMK UGM
(3) Departemen Obgin FKKMK UGM
(*) Corresponding Author

Abstract


Background: Ogilvie's syndrome is an acute abdominal condition characterized by massive colonic distension without any evidence of mechanical obstruction. In female patients this syndrome was associated with caesarean section and the use of spinal anaesthetics.

Case: We report a case of Ogilvie's syndrome that occurred after elective caesarean section. On the first day postoperative care the patient complained of lower abdominal pain accompanied by abdominal bloating. Physical examination reveals a distended abdomen without clinical evidence of peritonitis. Vital signs were normal and laboratory results showed an increase in leukocytes. An abdomen radiology was taken and shows gas distention in the large intestine which did not decrease even after given muscle relaxants. The patient then underwent emergency surgery by digestive surgeon followed by decompression measures for intestinal distention. The patient got a good postoperative care and continued control through the outpatient clinic.

Discussion: The exact mechanism that causes colonic dilatation in Ogilvie's syndrome is not known clearly, but many of these cases are associated with trauma, spinal anaesthesia, and pharmacological agents in which the autonomic nervous system (ANS) function is impaired. Diagnosis can be made by abdominal imaging which will show dilation of the large intestine. The main goal of treatment is to decompress the colon and thereby minimize the risk of colonic ischemia, perforation, and death. Pharmacological therapy should be considered in patients who fail conservative management within 24-48 hours, with the last resort being colonic decompression up to laparotomy with or without stoma creation.

Conclusion: Although it has a rare incidence, Ogilvie's syndrome has a high morbidity and mortality rate. Proper management of Ogilvie's Syndrome is carried out according to an algorithm starting from conservative management, pharmacology, to surgical management in resistant cases.

Key words: Ogilvie syndrome; acute abdomen; caesarean section complication.


Keywords


Ogilvie syndrome; acute abdomen; caesarean section complication.

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References

  1. Saputri, D., Josephine, C., Suparto, S., Oktavia, E., Mexcorry, E. (2022) Gambaran tingkat pengetahuan mengenai anastesi spinal operasi sectio caesaria pada wanita hamil di klinik ibu dan anak. Jurnal MedScientiae, 102-108.
  2. Laskin, M.D., Tessler, K., Kives, S. (2009) Cecal perforation due to paralytic ileus following primary caesarean section. J Obstet Gynaecol Can, 31(2),167-171.
  3. Vanek, V.W., Al-Salti, M. (1986) Acute pseudo-obstruction of the colon (Ogilvie's syndrome): An analysis of 400 cases. Dis Colon Rectum, 29(3), 203–10.
  4. Johnston, G., Vitikainen, K., Knight, R., Annest, L., Garcia, C. (1992) Changing perspective on gastrointestinal complications in patients undergoing cardiac surgery. Am J Surg, 163(5), 525–9.
  5. Ogilvie, W.H. (1987) Large-intestine colic due to sympathetic deprivation. A new clinical syndrome. Dis Colon Rectum, 30(12),984–7.
  6. Saunders, M.D. (2007) Acute colonic pseudo-obstruction. Best Pract Res Clin Gastroenterol, 21(4),671–87.
  7. Sloyer, A.F., Panella, V.S., Demas, B.E., et al. (1988) Ogilvie's syndrome: Successful management without colonoscopy. Dig Dis Sci, 33(11), 1391–6.
  8. Johnson, C.D., Rice, R.P., Kelvin, F.M., Foster, W.L., Williford, M.E. (1985) The radiologic evaluation of gross cecal distension: Emphasis on cecal ileus. AJR Am J Roentgenol, 145(6), 1211–7.
  9. Maloney, N., Vargas, H.D. (2005) Acute intestinal pseudo-obstruction (Ogilvie's syndrome). Clin Colon Rectal Surg, 18(2), 96–101.
  10. Turégano-Fuentes, F., Muñoz-Jiménez, F., Del Valle-Hernández, E., et al. (1997) Early resolution of Ogilvie's syndrome with intravenous neostigmine: A simple, effective treatment. Dis Colon Rectum, 40(11),1353–7.
  11. MacColl, C., MacCannell, K.L., Baylis, B., Lee, S.S. (1990) Treatment of acute colonic pseudoobstruction (Ogilvie's syndrome) with cisapride. Gastroenterology, 98(3), 773–6.
  12. Carlino, W., Hanna, H., Eskandar, O. (2017) Post cesarean section acute colonic pseudo-obstruction (Ogilvie syndrome): A case report. J Case Rep Images Gynecol Obstet, 3, 27–31.



DOI: https://doi.org/10.22146/jkr.85194

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