Hypothyroidism

Ogilvie s syndrome from hypothyroidism: Abdominal compartment syndrome secondary to myxedema ileus

Batke M, Cappell M.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. If laparotomy is performed on the patient with ileus, the complications of myxedema coma and death may follow. Acute pseudo-obstruction of the colon Ogilvie's syndrome. Singapore Med J. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal.

  • Decreased abdominal wall compliance, increased intra-abdominal contents, and increased capillary leak increase IAP. There are varied causes of this acute dilatation.

  • Free full text. Ogilvie's syndrome: Successful management without colonoscopy.

  • On contrast-enhanced computed tomography CECT abdomen, the colon appeared distended with maximum cecal diameter of 12 cm [ Figure 2b ]. The small bowel was collapsed.

  • A clinical response is typically seen within 2 to 30 minutes of administration.

  • J Clin Endocrinol Metab.

We considered diagnosis of ACPO as no mechanical cause could be identified as responsible for the obstruction and duration of disease was less than 6 days. Acute colonic pseudo-obstruction Ogilvie's syndrome : Presentation of 14 of our own cases and analysis of cases reported in the literature. Financial support and sponsorship Nil. Despite these measures, the altered sensorium and abdominal distension persisted.

Electroencephalogram EEG revealed diffuse slowing suggestive of a metabolic encephalopathy. Bastenie PA. Dis Colon Rectum. J R Coll Surg Edinb. Durai R. Abdomen was distended; there was no guarding or rigidity.

Wegener M, Borsch G. Intestinal disorders in hypothyroidism: Clinical and manometric study. CT scan can also show signs of ischemia such as mucosal wall thickening, submucosal edema, or gas. Related articles Acute colonic pseudo-obstruction hypothyroidism myxedema Ogilvie's syndrome.

Myxedema as a cause of pseudo-obstruction is extremely rare. If laparotomy is performed on the patient with ileus, the complications of myxedema coma and death may follow. Am Surg.

  • Intraoperative image showing massively dilated large bowel loops. The abdomen was distended, and the intra-abdominal pressure IAP of the patient was 40 cm of water

  • Academic Editor: Yoshio Yoshida. Home Diseases Ogilvie syndrome.

  • There were no distended bowel loops on abdominal radiograph on follow-up.

  • Intraoperative image showing massively dilated large bowel loops. Myxedema ileus MI as a cause of acute pseudo-obstruction is rare.

On neurological evaluation, the patient was conscious but drowsy, and was unable to recognize the relatives. Hematological investigations showed hemoglobin of Intestinal pseudo-obstruction. A year-old female presented to emergency with a history of pain abdomen and nonpassage of flatus and stools for the past 3 days and altered sensorium for the past 1 day.

Retrospective study of neostigmine for the treatment of acute colonic pseudo-obstruction. If not associated with underlying disease, leukocytosis, elevated CRP, or lactate are concerning for bowel ischemia. If a perforation is not present, a cecostomy decompression procedure can be attempted. Ambulation, if possible, or frequent patient repositioning may help move intestinal gas. Surgery is reserved for patients with clinical deterioration or with evidence of colonic ischemia or perforation. Some electrolyte imbalances like hyponatremia, hypomagnesemia, and hypokalemia can be seen in ACPO, but they represent a consequence of the pathological condition rather than its etiologic factor. Aliment Pharmacol Ther.

Myxedema ileus: A form of intestinal pseudoobstruction. Surgery is reserved for patients with clinical deterioration or with evidence of colonic ischemia or perforation. Newman, M. Colonic motility was restored only on starting thyroxin.

Enhancing Healthcare Team Outcomes Ogilvie syndrome can occur due to many causes and is best managed by an interprofessional team that includes a surgeon, radiologist, ogilvie s syndrome from hypothyroidism, nurse practitioner, and gastroenterologist. Duration of ACPO appears to be the greatest factor for perforation or ischemia, with dilation lasting more than 5 or 6 days conferring the highest risk and having a direct impact on mortality. Large-intestine colic due to sympathetic deprivation: A new clinical syndrome. On contrast-enhanced computed tomography CECT abdomen, the colon appeared distended with maximum cecal diameter of 12 cm [ Figure 2b ].

Figure 2. ACPO is diagnosed by excluding mechanical large bowel obstruction LBO characterized by more severe abdominal symptoms and signs. On contrast-enhanced computed tomography CECT abdomen, the colon appeared distended with maximum cecal diameter of 12 cm [ Figure 2b ]. Intestinal obstruction and ileus. Photochem Photobiol. Colonoscopic decompression for acute pseudoobstruction of the colon Ogilvie's syndrome. No previous case report has documented myxedema coma presenting as ACPO.

Anil Menon Search articles by 'Anil Menon'. Almost all investigators ogilvie s syndrome from hypothyroidism that there is impairment hupothyroidism the colonic motor system, with dysfunction or imbalance of the autonomic nervous system being the most likely cause. The etiological factors in our case were as follows: 1 a multiparous patient; 2 previous repeated cesarean sections; 3 hormonal effect of pregnancy, GDM, and hypothyroidism; 4 receiving spinal anesthesia; and 5 age 40 years old. Turk J Gastroenterol. Endocr Pract20 801 Aug Clinical and radiological findings are both needed to confirm the diagnosis of the syndrome [ 10 ].

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The small bowel was collapsed. On 1-month follow-up, there were no complaints, ogilgie syndrome from hypothyroidism no episode of constipation, ability to tolerate ogilvie had improved, and in general, there was a feeling of well-being. Perforation is the most common complication associated with acute megacolon [ 2 ]. A clinical diagnosis of intestinal obstruction with acute compartment syndrome was made. She was started on broad-spectrum antibiotics empirically due to the presence of fever; however, no focus of sepsis could be identified.

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CT scan can also show signs of ischemia such as mucosal wall thickening, submucosal ogilvie s syndrome from hypothyroidism, or gas. Prognosis The expected prognosis is confounded by the association of multiple co-morbidities in the usual patient population as well as the underlying disease contributing to the development of ACPO. The resolution of disease is defined clinically as the passage of flatus or stool and or decreasing cecal diameter. Abdomen was distended; there was no guarding or rigidity. J Neurogastroenterol Motil. National Institutes of Health. Treatment of acute colonic pseudo-obstruction with neostigmine.

Patients should attempt to ambulate as frequently as clinically tolerated and while in bed should be encouraged to lie prone or in a knee-to-chest position with frequent turns to promote passage of flatus. Frequent repeat abdominal examinations are required. Exploration laparotomy performed through longitudinal abdominal incision. Close Copy Link. Turk J Gastroenterol.

StatPearls [Internet].

Keller J, Layer P. Do you know of an organization? Ogilvie syndrome.

It may be primary congenital and secondary acquired. External link. No previous case report has documented myxedema coma presenting as ACPO. Declaration of patient consent We certify that we have obtained appropriate patient consent form. Myxedema pseudovolvulus: Case series and review of the literature.

Please review our privacy policy. There was a history of constipation off and on hupothyroidism which she used to take laxatives. OS due to hypothyroidism is known as MI. We are reporting a year female who presented to us in the emergency department with acute compartment syndrome due to MI. Along with this, there was cold intolerance and generalized xerosis.

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Review [Acute colonic pseudo-obstruction: Ogilvie syndrome]. Shahait AD, Mostafa G. Intestinal obstruction and ileus.

  • The patient improved and was extubated on the postoperative day 3. Colonic motility is controlled by neurogenic and myogenic factors, so any myopathy of colon or imbalance between sympathetic and parasympathetic innervation of colonic musculature may manifest as pseudo-obstruction [ 5 ].

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  • Indian J Endocrinol Metab.

The encephalopathy was ogi,vie to be resulting from hyponatremia. This article has been cited by other articles in PMC. Br Med J ; Large-intestine colic due to sympathetic deprivation: A new clinical syndrome. Caring for Your Patient with a Rare Disease. Invasive procedures or surgery are indicated for disease refractory to conservative therapy or for those with a more severe initial presentation.

Br Med J. Laxatives are generally avoided because fluid tends to accumulate in the bowel. Along with this, there was cold intolerance and generalized xerosis. Corresponding Author: Dr. Am J Surg. Financial support and sponsorship Nil. It was first described by Sir Heneage Ogilvie in [ 1 ].

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Large-intestine colic due to sympathetic deprivation: A new clinical syndrome. Med Clin N Am. OS due to hypothyroidism is known as MI.

Ogilvie with frim, there was cold syndrome from hypothyroidism and generalized xerosis. One study on the prevalence of ACPO as a postoperative complication of hip arthroplasty recorded 3 out of 30 cases to have underlying hypothyroidism prior to surgery. An impression of encephalopathy secondary to hyponatremia was made. Despite these measures, the altered sensorium and abdominal distension persisted.

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Source of Support: Nil. Paralytic ileus in severe hypothyroidism. Investigation revealed hyponatremia and acute colonic pseudo-obstruction. Abdomen was distended; there was no guarding or rigidity. Best Pract Res Clin Gastroenterol. Conflicts of interest There are no conflicts of interest.

Clinical and radiological findings are both needed to confirm the diagnosis of the syndrome [ 10 ]. They ogilvie s syndrome from hypothyroidism direct you to research, resources, and services. Other pharmacological agents are naloxone and cisapride [ 5 ]. Though X-ray is a fundamental diagnostic modality, other modalities like CT scans and water soluble contrast enema are used to confirm the diagnosis and to exclude mechanical obstruction [ 10 ]. Thyroid profile was suggestive of primary hypothyroidism. Search articles by 'Uday Yanamandra'.

Giles, and K. Turk J Gastroenterol. Independent dysfunction of the enteric nervous system, as well as the intrinsic enteric reflex arcs and pacemaker activity also contribute but to what degree is unknown.

Ogilvie study on the prevalence of ACPO as syndrome from postoperative complication of hip arthroplasty recorded 3 out of 30 cases to have underlying hypothyroidism prior to hypothyroidism. A year-old female presented to emergency with a history of pain abdomen and nonpassage of flatus and stools for the past 3 days and altered sensorium for the past 1 day. Our patient presented with altered sensorium and abdominal distension. Acute pseudo-obstruction of the colon is known as Ogilvie syndrome OS.

Access Statistics. Ogilvie described in [ 1 ] a syndrome of acute colonic obstruction associated with retroperitoneal malignancy. Wyndrome Pseudo Obstruction of the colon as a post operative complication of hip arthroplasty. Nutr Clin Pract. Atropine for symptomatic bradycardia should be available per ACLS guidelines. The average age at presentation is approximately 60 years. The case is illustrative of the need to consider hypothyroidism, a common endocrine disorder, in the differential diagnosis of Ogilvie's.

Open in a separate window. Postoperative period was uneventful, and the patient was discharged on the postoperative day 8 on treatment for hypothyroidism with oral thyroxine. Acute colonic pseudo-obstruction. Dig Dis Sci. Decreased abdominal wall compliance, increased intra-abdominal contents, and increased capillary leak increase IAP.

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We present a rare case of a year-old female who was operated for abdominal compartment syndrome secondary to MI. Routine hematological investigations were done which revealed hemoglobin of 8. The possible precipitants leading to ACPO could have been dyselectrolytemia and sepsis. Sympathetic innervation leads to contraction and parasympathetic to dilatation.

Any associated electrolyte abnormalities should be corrected cautiously as they may aggravate pseudo-obstruction. Arterial blood gas examination showed pH of 7. In the postoperative period, the patient was started on intravenous thyroxine. Acute colonic pseudo-obstruction.

Catchpole Ogilvie s syndrome from hypothyroidism. Hypothyrodism was distended; there was no guarding or rigidity. Hypothyroidism was not recognized at presentation as it was masked by the sepsis and dyselectrolytemia. A prospective study. We present a rare case of a year-old female who was operated for abdominal compartment syndrome secondary to MI. Pathologic changes in adult myxedema: Survey of 10 necropsies. Myxedema as a cause of pseudo-obstruction is extremely rare.

It is suspected that there is reduced activity of stimulatory neurotransmitters, chiefly acetylcholine, ogilvie s syndrome from hypothyroidism to that of the inhibitory neurotransmitters, nitrous oxide, and vasoactive intestinal peptide. Symptoms and signs of the disease usually manifest over 3 to 5 days but may also develop more acutely, sometimes within 48 hours. Davis, and L. Patients should attempt to ambulate as frequently as clinically tolerated and while in bed should be encouraged to lie prone or in a knee-to-chest position with frequent turns to promote passage of flatus. Chirurgia Bucur.

Singapore Med J. Sympathetic innervation leads to contraction and parasympathetic to dilatation. Support Center Support Center. Ogilbie theories have been proposed to explain hypoactive gut in hypothyroidism, including autonomic neuropathy, decreased impulse transmission at the myoneural junction, intestinal edema and ischemia, reduction in adrenergic receptors, and intestinal myopathy. Postoperative period was uneventful, and the patient was discharged on the postoperative day 8 on treatment for hypothyroidism with oral thyroxine.

The bradycardia and junctional rhythm were unmasked only after treatment of the sepsis. As hypothyroidism over medication symptoms hypothyroid state becomes more severe, intestinal hypomotility may progress hypothyroidosm atony, ileus, prolapse or volvulus. Acute colonic pseudo-obstruction. The abdomen is a closed cavity with a normal pressure of 5 mmHg. Thyroid profile was suggestive of primary hypothyroidism. Large-intestine colic due to sympathetic deprivation; a new clinical syndrome. Role of nitric oxide in the colon of patients with slow-transit constipation.

Thyroid function tests of the patient revealed thyroid function test TSH of Open in a separate window. Perforation of cecum is the most common. Catchpole BN. Retrospective study of neostigmine for the treatment of acute colonic pseudo-obstruction.

Conclusion: Ogilvie's syndrome is a rare condition yet of interest to obstetricians, midwifery staff, and general surgeons because its early diagnosis and prompt treatment are the keystones to avoid any subsequent fatal complications. The ECG reverted to sinus rhythm. They can direct you to research, resources, and services.

Do you have updated information on this disease? Wegener M, Borsch G. Shakir, M. Remy P. Management for uncomplicated patients is ogilvie s syndrome from hypothyroidism conservative with limiting oral intake, active mobilization, cessation of opioids, and correction of electrolytes, and underlying comorbidities should be treated [ 14 ]. Bowel sounds were not heard, tympanitic note was present all over abdomen. On POD2, the patient started to have more abdominal distension despite passing stool, and bowel sounds become sluggish then nonaudible.

Cebola, E. Haack H. Etiology The development of acute colonic pseudo-obstruction is unpredictable, and there are no definite causes; however, many clinical conditions that place a patient at increased risk have been identified. N Engl J Med. Appropriate imaging is essential to the diagnosis and management of ACPO.

To the best of our knowledge, acute pseudo-obstruction presenting with compartment syndrome due to MI has never been reported. The patient was immediately intubated and was resuscitated. Colonoscopy and acute colonic pseudo-obstruction. There was no transition point.

There was a history of constipation off and on for which hypothyroidism over medication symptoms used to take laxatives. The ECG reverted to sinus rhythm. Am J Surg. Thyroid function tests of the patient revealed thyroid function test TSH of Decompression alone will recur until myxedema is treated. Surgery is reserved for patients with clinical deterioration or with evidence of colonic ischemia or perforation. A prospective study.

We certify that we have obtained appropriate patient consent form. Br Med Hypothyroidism over medication symptoms. Along with this, there was cold intolerance and generalized xerosis. Tzu Chi Med J. Hypothyroidism was not recognized at presentation as it was masked by the sepsis and dyselectrolytemia. Financial support and sponsorship Nil. Colonic motility is controlled by neurogenic and myogenic factors, so any myopathy of colon or imbalance between sympathetic and parasympathetic innervation of colonic musculature may manifest as pseudo-obstruction [ 5 ].

Furthermore, in patients like ours, presenting with compartment syndrome active decompression and damage control laparotomy is required. Declaration of patient consent We certify that we have obtained appropriate patient consent form. A prospective study.

  • Intraoperative image showing massively dilated large bowel loops.

  • A year-old lady presented with fever, altered sensorium, obstipation, bradycardia and abdominal distension.

  • Conservative management involves bowel rest, decompression by nasogastric tube, and rectal tube at least for 2 days.

  • CT scan can also show signs of ischemia such as mucosal wall thickening, submucosal edema, or gas.

At present, the patient was not on ogilvie s syndrome from hypothyroidism medications even not taking thyroid replacement therapy. It may be primary congenital and secondary acquired. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. Polyethylene glycol matrix reduces the rates of photochemical and thermal release of nitric oxide from S-niroso-N-acetylcysteine.

JAMA ; Figure 1. Jesudason, and B. Ogilvie's syndrome should be diagnosed only after excluding mechanical causes for colonic obstruction.

Maloney N, Vargas HD. We certify that we have obtained appropriate patient consent form. We conclude hypothyroidism to be a cause of Ogilvie's syndrome. Ogilvie H. Learn More. Any associated electrolyte abnormalities should be corrected cautiously as they may aggravate pseudo-obstruction.

Patient ogilvie s syndrome from hypothyroidism kept nil per orally NPO and started on parenteral nutrition. Similarly, leukocytosis can be present, especially with perforation or bowel ischemia. Acute colonic pseudo-obstruction ACPOknown as Ogilvie syndrome, is a distinct form of colonic dilatation occurring in the absence of underlying mechanical or anatomic etiology. Khajehnoori and S.

Br Med J. Sleisenger and Fordtran's gastrointestinal and liver disease: Pathophysiology, diagnosis, and management. Figure 2. ACPO is diagnosed by excluding mechanical large bowel obstruction LBO characterized by more severe abdominal symptoms and signs.

The initial therapy remains conservative with supportive measures correction oyilvie metabolic, infectious or pharmacologic ogilvie s syndrome from hypothyroidism followed by neostigmine and decompressive colonoscopy. Myxedema ileus: A form of intestinal pseudoobstruction. Dudley[ 2 ] in recognized the obstruction to be due to functional rather than mechanical causes and named it as acute colonic pseudo-obstruction ACPO. Bastenie PA. Hence a final diagnosis of acute compartment syndrome secondary to acute pseudo-obstruction due to myxedema ikeus was made. The patient had pallor, with no icterus, cyanosis and pedal edema. J Endocrinol.

Conflict of Interest: None declared. Sympathetic innervation leads to contraction and parasympathetic to dilatation. National Center for Biotechnology InformationU.

Am Surg. Author information Copyright and License information Disclaimer. Electrolyte abnormalities should be aggressively corrected as well as any other underlying disease exacerbations. Undiagnosed hypothyroidism presenting with sigmoid volvulus. Assess to rule out the presence of mechanical obstruction and to evaluate for perforation as this will terminate conservative management.

PMID: Ogilvie s syndrome from hypothyroidism was not recognized at presentation as it was masked by the sepsis and dyselectrolytemia. Large-intestine colic due to sympathetic deprivation: A new clinical syndrome. Organizations Providing General Support. Rom J Gastroenterol12 101 Mar These resources provide more information about this condition or associated symptoms. Colonoscopy and acute colonic pseudo-obstruction.

  • Ogilvie described in [ 1 ] a syndrome of acute colonic obstruction associated with retroperitoneal malignancy.

  • Management for uncomplicated patients is initially conservative with limiting oral intake, active mobilization, cessation of opioids, and correction of electrolytes, and underlying comorbidities should be treated [ 14 ].

  • We considered diagnosis of ACPO as no mechanical cause could be identified as responsible for the obstruction and duration of disease was less than 6 days.

  • Indian J Endocr Metab [serial online] [cited Jul 16];

  • Peritoneal lavage was performed afterwards, 2 abdominal drains were inserted, and the incision site was closed with staples. ACPO is considered complicated when the patient develops any evidence of bowel ischemia, peritonitis, or perforation; the risk of complication increases directly with increasing cecal diameter and duration of illness.

Corresponding Author: Dr. Postoperative period was hypothyroidism over medication symptoms, and the patient was discharged on the postoperative day 8 on treatment for hypothyroidism with oral thyroxine. There is a deficiency of nitric oxide in hypothyroidism which is further responsible for gut motility disorder [ 8 ]. Arterial blood gas examination showed pH of 7. Bowel sounds were not heard, tympanitic note was present all over abdomen. The patient also had a history of easy fatigability.

Conflicts of interest There are no conflicts of interest. A year-old female ogilvie s syndrome from hypothyroidism to emergency with a history of pain abdomen and nonpassage of flatus and stools for the past 3 days and altered sensorium for the past 1 day. The main theories involve an imbalance of autonomic influences, which produces a hypotonic bowel, either through increased sympathetic activity or through decreased parasympathetic activity. Please review our privacy policy. Am Surg. This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.

There were no distended bowel loops on abdominal radiograph on follow-up. Ogilvie s syndrome from hypothyroidism contrast-enhanced computed tomography CECT abdomen, the colon appeared distended with maximum cecal diameter of 12 cm [ Figure 2b ]. Dudley[ 2 ] in recognized the obstruction to be due to functional rather than mechanical causes and named it as acute colonic pseudo-obstruction ACPO.

Medicine Baltimore97 27 :e, 01 Jul Other Names:. The case is illustrative of the need to consider hypothyroidism, a common endocrine disorder, in the differential diagnosis of Ogilvie's. Clinical strategies for the management of intestinal obstruction and pseudo-obstruction.

Bowel sounds were not heard, tympanitic note was present all over abdomen. Thyroid profile was suggestive of primary hypothyroidism. Myxedema ileus: A form of intestinal pseudoobstruction. The transition between dilated and collapsed bowel is usually near the splenic flexure but can occasionally occur in the distal or sigmoid colon. National Center for Biotechnology InformationU.

Tzu Chi Med J. Open in a separate window. It presents clinically as acute dilatation of cecum and colon.

Abstract Ogilvie's syndrome [acute colonic pseudo-obstruction ACPO ] presents as massive colonic dilatation without a mechanical cause, usually in critically ill patients due to imbalanced sympathetic and parasympathetic activity. It is postulated to occur due to imbalance between sympathetic and parasympathetic innervations of the large bowel. Financial support and sponsorship Nil. Dig Dis Sci.

Renal and liver functions were normal. External link. Retrospective hypothyroidisj of neostigmine for the treatment of acute colonic pseudo-obstruction. Investigation revealed hyponatremia and acute colonic pseudo-obstruction. Patients frequently have symptoms of bloating, flatulence, and constipation. This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.

There was a history of thyroid surgery 20 years ago. Basal metabolic hypothhyroidism is reduced in hypothyroidism and so is the activity of the gastrointestinal system. On contrast-enhanced computed tomography CECT abdomen, the colon appeared distended with maximum cecal diameter of 12 cm [ Figure 2b ]. Colonic pseudo-obstruction. A possibility of hypothyroidism was considered due to the presence of bradycardia, hyponatremia and altered sensorium.

Abstract Acute ogilvie s syndrome from hypothyroidism of the colon is known as Ogilvie syndrome OS. It may be primary congenital and secondary acquired. Polyethylene glycol matrix reduces the rates of photochemical and thermal release of nitric oxide from S-niroso-N-acetylcysteine. The patient understands that her name and initial will not be published and due efforts have been made to conceal her identity, but anonymity cannot be guaranteed.

Enterotomy and colonic decompression were done. The bradycardia and junctional rhythm were unmasked only after treatment of the sepsis. Sleisenger and Fordtran's gastrointestinal and liver disease: Pathophysiology, diagnosis, and management. Financial support and sponsorship Nil. Figure 1. Intestinal obstruction and ileus.

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Am J Dig Dis ; Although bowel obstruction is classically taught to be associated with constipation and obstipation, a ogilvie s syndrome from hypothyroidism number of patients with ACPO will continue to have some degree of bowel function, and diarrhea is possible due to hypersecretion of water. Thyroid profile was suggestive of primary hypothyroidism. Rom J Gastroenterol12 101 Mar Acute colonic pseudo-obstruction Ogilvie's syndrome. Recent Activity.

History and Physical Patients with acute colonic pseudo-obstruction will present with gradually worsening abdominal distension and some degree of abdominal discomfort. JAMA ; J Am Coll Surg ; This website requires cookies, and the limited processing of your personal data in order to function. Newman, M.

Release reflexes or cranial nerve deficit were not present, gag reflex was preserved, the patient was moving all ogilvie s syndrome from hypothyroidism limbs, cerebellum could not be assessed, there was no neck rigidity. Neostigmine for the treatment of acute colonic pseudo-obstruction. We considered diagnosis of ACPO as no mechanical cause could be identified as responsible for the obstruction and duration of disease was less than 6 days. There was no growth, volvulus, or adhesions. Declaration of patient consent We certify that we have obtained appropriate patient consent form.

Figure 2. Enterotomy and colonic decompression were done. Tzu Chi Med J. The patient understands that her name and initial will not be published and due efforts have been made to conceal her identity, but anonymity cannot be guaranteed. National Center for Biotechnology InformationU.

Table 1. Case Report. Patients should be carefully resuscitated with fluid as indicated. The average age at presentation is approximately 60 years.

By Day 11she was feeding orally and constipation was relieved. Dehydration, electrolyte imbalance, hyponatremia, and hypokalemia may be seen [ 2 ]. Large-intestine colic due to sympathetic deprivation; a new clinical syndrome. There are varied causes of this acute dilatation. Perforation is the most common complication associated with acute megacolon [ 2 ]. The abdominal distension regressed gradually and sensorium improved.

The term myxedema ileus MI is used when Ogilvie is due to hypothyroidism. Dig Dis Sci. Intestinal pseudo-obstruction. She was started on broad-spectrum antibiotics empirically due to the presence of fever; however, no focus of sepsis could be identified. Thyroid profile was suggestive of primary hypothyroidism.

The bradycardia and junctional rhythm were unmasked only after syndrmoe of the sepsis. On POD2, the patient started to have more abdominal distension despite passing stool, and bowel sounds become sluggish then nonaudible. Camilleri M. Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Evaluation of gastrointestinal motility with MRI: Advances, challenges and opportunities.

  • Abdominal X-ray of the patient showing distended large bowel with elevated diaphragm. Br Med J.

  • This book is distributed under the terms of the Creative Commons Attribution 4. Patients with diarrhea should be evaluated for Clostridium difficile toxin.

  • We present a rare case of a year-old female who was operated for abdominal compartment syndrome secondary to MI.

  • Colonoscopic decompression for acute pseudoobstruction of the colon Ogilvie's syndrome. Ambulation, if possible, or frequent patient repositioning may help move intestinal gas.

  • Our patient presented with altered sensorium and abdominal distension. The possible precipitants leading to ACPO could have been dyselectrolytemia and sepsis.

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OS is an acute colonic pseudo-obstruction. Please review our privacy policy. Batke M, Cappell M. Sympathetic innervation leads to contraction and parasympathetic to dilatation.

Hence a final diagnosis of acute compartment syndrome secondary to acute pseudo-obstruction due to myxedema ikeus was made. Acute colonic pseudo-obstruction Ogilvie's syndrome : Presentation of 14 of our own cases and analysis of cases reported in the literature. Ogilvie's syndrome: Successful management without colonoscopy. To the best of our knowledge, acute pseudo-obstruction presenting with compartment syndrome due to MI has never been reported. Acute pseudo-obstruction of the colon Ogilvie's syndrome.

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