Colonic pseudo-obstruction; Ogilvie syndrome; neostigmine; decompression; caecostomy
Abstract
Acute colonic pseudo-obstruction is characterised by massive colonic distension without distal mechanical obstruction. It affects a wide variety of patients who often have multiple comorbidities, which makes studies on pseudo- obstruction difficult to perform and interpret. Few advances have been made in recent years in our understanding and management, which remain challenging. This article explores and provides interpretation of the key studies and concepts that have shaped our management of this condition.
References
Ogilvie H. Large-intestine colic due to sympathetic deprivation; a new clinical syndrome. Br Med J. 1948;2(4579):671-3.
vogel JD, Feingold DL, Stewart DB, Turner JS, Boutros M, Chun J, et al. Clinical Practice Guidelines for Colon volvulus and Acute
Colonic Pseudo-Obstruction. Dis Colon Rectum. 2016;59(7):589-600.
Committee ASoP, Harrison Me, Anderson MA, Appalaneni v, Banerjee S, Ben-Menachem T, et al. The role of endoscopy in the management of patients with known and suspected colonic obstruction and pseudo-obstruction. Gastrointest Endosc. 2010;71(4):669- 79.
Manuel D. Chronic Megacolon 2016 [updated March 2016]. Available from: http://emedicine.medscape.com/article/180955-
overview.
Bernardi MP, warrier S, Lynch AC, Heriot AG. Acute and chronic pseudo-obstruction: a current update. ANZ J Surg.
;85(10):709-14.
vanek vw, Al-Salti M. Acute pseudo-obstruction of the colon (Ogilvie’s syndrome). An analysis of 400 cases. Dis Colon rectum.
;29(3):203-10.
Saunders MD. Acute colonic pseudo-obstruction. Best Pract Res Clin Gastroenterol. 2007;21(4):671-87.
Stephenson BM, Morgan Ar, Drake N, Salaman Jr, wheeler MH. Parasympathomimetic decompression of acute colonic pseudo-
obstruction. Lancet. 1993;342(8880):1181-2.
Jain A, vargas HD. Advances and challenges in the management of acute colonic pseudo-obstruction (ogilvie syndrome). Clin Colon
Rectal Surg. 2012;25(1):37-45.
Stewart J, Finan PJ, Courtney DF, Brennan TG. Does a water soluble contrast enema assist in the management of acute large bowel
obstruction: a prospective study of 117 cases. Br J Surg. 1984;71(10):799-801.
Jacob Se, Lee SH, Hill J. The demise of the instant/unprepared contrast enema in large bowel obstruction. Colorectal Dis.
;10(7):729-31.
Beattie GC, Peters rT, Guy S, Mendelson rM. Computed tomography in the assessment of suspected large bowel obstruction. ANZ J
Surg. 2007;77(3):160-5.
Choi JS, Lim JS, Kim H, Choi JY, Kim MJ, Kim NK, et al. Colonic pseudoobstruction: CT findings. AJr Am J roentgenol.
;190(6):1521-6.
Schermer Cr, Hanosh JJ, Davis M, Pitcher De. Ogilvie’s syndrome in the surgical patient: a new therapeutic modality. J Gastrointest
Surg. 1999;3(2):173-7.
Davis L, Lowman RM. An evaluation of cecal size in impending perforation of the cecum. Surg Gynecol Obstet. 1956;103(6):711-8.
Sloyer AF, Panella vS, Demas Be, Shike M, Lightdale CJ, winawer SJ, et al. Ogilvie’s syndrome. Successful management without
colonoscopy. Dig Dis Sci. 1988;33(11):1391-6.
wegener M, Borsch G. Acute colonic pseudo-obstruction (Ogilvie’s syndrome). Presentation of 14 of our own cases and analysis of
cases reported in the literature. Surg Endosc. 1987;1(3):169-74.
Geller A, Petersen BT, Gostout CJ. endoscopic decompression for acute colonic pseudo-obstruction. Gastrointest endosc.
;44(2):144-50.
Harig JM, Fumo De, Loo FD, Parker HJ, Soergel KH, Helm JF, et al. Treatment of acute nontoxic megacolon during colonoscopy:
tube placement versus simple decompression. Gastrointest Endosc. 1988;34(1):23-7.
Lavignolle A, Jutel P, Bonhomme J, Cloarec D, Cerbelaud P, Lehur PA, et al. [Ogilvie’s syndrome: results of endoscopic exsufflation in a series of 29 cases]. Gastroenterol Clin Biol. 1986;10(2):147-51.
R ex DK. Colonoscopy and acute colonic pseudo-obstruction. Gastrointest Endosc Clin N Am. 1997;7(3):499-508.
Tsirline vB, Zemlyak AY, Avery MJ, Colavita PD, Christmas AB, Heniford BT, et al. Colonoscopy is superior to neostigmine in the
treatment of Ogilvie’s syndrome. Am J Surg. 2012;204(6):849-55; discussion 55.
Tobin G, Giglio D, Lundgren O. Muscarinic receptor subtypes in the alimentary tract. J Physiol Pharmacol. 2009;60(1):3-21.
Valle RG, Godoy FL. Neostigmine for acute colonic pseudo-obstruction: A meta-analysis. Ann Med Surg (Lond). 2014;3(3):60-4.
Ponec rJ, Saunders MD, Kimmey MB. Neostigmine for the treatment of acute colonic pseudo-obstruction. N engl J Med.
;341(3):137-41.
Mehta r, John A, Nair P, raj vv, Mustafa CP, Suvarna D, et al. Factors predicting successful outcome following neostigmine therapy
in acute colonic pseudo-obstruction: a prospective study. J Gastroenterol Hepatol. 2006;21(2):459-61.
Cronnelly r, Stanski Dr, Miller rD, Sheiner LB, Sohn YJ. renal function and the pharmacokinetics of neostigmine in anesthetized
man. Anesthesiology. 1979;51(3):222-6.
elsner JL, Smith JM, ensor Cr. Intravenous neostigmine for postoperative acute colonic pseudo-obstruction. Ann Pharmacother.
;46(3):430-5.
Gillespie CJ, Lu CT, von Papen M, Asoka G, Hewett P, wattchow DA. Subcutaneous neostigmine – a safe alternative in acute colonic pseudo-obstruction. Association of Coloproctology of Great Britain and Ireland Annual Conference; July; Liverpool, United Kingdom2013.
Wiersema US, Bruno MJ, Tjwa ET. On colonoscopy in acute colonic pseudo obstruction. Eur J Intern Med. 2013;24(8):e86-7.
weinstock LB, Chang AC. Methylnaltrexone for treatment of acute colonic pseudo-obstruction. J Clin Gastroenterol.
;45(10):883-4.
Nalamachu Sr, Pergolizzi J, Taylor r, Jr., Slatkin Ne, Barrett AC, Yu J, et al. efficacy and Tolerability of Subcutaneous Methylnaltrexone in Patients with Advanced Illness and Opioid-Induced Constipation: A responder Analysis of 2 randomized, Placebo-Controlled Trials. Pain Pract. 2015;15(6):564-71.
Sgouros SN, vlachogiannakos J, vassiliadis K, Bergele C, Stefanidis G, Nastos H, et al. effect of polyethylene glycol electrolyte balanced solution on patients with acute colonic pseudo obstruction after resolution of colonic dilation: a prospective, randomised, placebo controlled trial. Gut. 2006;55(5):638-42.
Mourelle M, Casellas F, Guarner F, Salas A, riveros-Moreno v, Moncada S, et al. Induction of nitric oxide synthase in colonic
smooth muscle from patients with toxic megacolon. Gastroenterology. 1995;109(5):1497-502.
Shishido SM, de Oliveira MG. Polyethylene glycol matrix reduces the rates of photochemical and thermal release of nitric oxide from
S-nitroso-N-acetylcysteine. Photochem Photobiol. 2000;71(3):273-80.
Duh QY, way Lw. Diagnostic laparoscopy and laparoscopic cecostomy for colonic pseudo-obstruction. Dis Colon rectum.
;36(1):65-70.
Baraza w, Brown S, McAlindon M, Hurlstone P. Prospective analysis of percutaneous endoscopic colostomy at a tertiary referral
centre. Br J Surg. 2007;94(11):1415-20.
Maloney N, Vargas HD. Acute intestinal pseudo-obstruction (Ogilvie’s syndrome). Clin Colon Rectal Surg. 2005;18(2):96-101.
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