Large-intestine Colic due to Sympathetic Deprivation

Abstract

SURGERY OF CONGENITAL HEART DISEASE BJxoRsH 671 congenital heart disease there were almost equal numbers in each year up to 7, three-fifths of this number in each year from 8 to 11, and one-fifth of this number in each year from 12 to 22, after which there were only scattered cases. The figures suggest that those surviving infancy have no great 'risks until they reach the age of 7, though clinical experience hardly bears this out. After 7 the chances of surviving become less, and increasingly so after the age of 12.If these figures can be taken as giving a true crosssection they mean that only one patient in ten reaches the age of 24 and only two in ten the age of 12. Many parents have been told that their children will not live to 7 or to 14 or to 21, and there seems some rough truth in these three round numbers as representing periods of increasing danger beyond which survival becomes less likely. During the last few months there have been some deaths after operation, but there have been many more among the other patients I have seen. These considerations seem ample justification for advising operation in spite of the relatively high mortality. The operation is essentially an anastomosis between a systemic artery and the pulmonary artery, most commonly an end-to-side subclavian-pulmonary anastomosis, though under special circumstances the innominate or carotid artery may be used or the anastomosis may be end-to-end. In onequarter of these cases the aortic arch will be right-sided instead of curving back as usual to the left and this will of course change the position of the innominate artery. The operation should be performed on the side opposite to the aortic arch because this gives a greater choice of systemic vessels that can be used and the subclavian artery can generally be turned down to the pulmonary artery with a less acute angle.In infants the small size of the vessels produces a surgical problem of the greatest difficulty, and the operation is much more dangerous and sometimes less lasting in its good effect because the anastomosis is too small as the child grows larger. For Results of OperationThe operation is not of course curative in the same way as in the other two groups because the underlying abnormality remains, but the improvement may be so great that the child appears normal to the parents. The immediate upset caused by the operation is less than might be expected, and intravenous fluid is often not required; when it is used only small amounts are needed. Many have a pleural effusion that often needs aspiration, but generally only once; other complications are not common. Of the first 38 cases operated on at Guy's Hospital 6 died, 7 could not have an anastomosis done or did not benefit much, and the remaining 25 were enormously improved almost at once, and this has been maintained.The immediate results of the operation are excellent, and the improvement seems to be maintained over the period of two to three years for which it has been possible to follow up Blalock's patients. The colo...

Ogilvie Syndrome - An Acute Pseudo-Colonic Obstruction One Week Following Caesarean Section: A Case Report

“…1 Ogilvie hypothesized that the aetiology of their conditions was due to an imbalance in the autonomic nervous system with sympathetic deprivation to the colon, leading to unopposed parasympathetic tone and regional contraction, resulting in functional obstruction. 1 Treatment is mainly conservative, however, the colon may become massively dilated and if not decompressed, the patient is at risks of perforation, peritonitis and death. 1,3,5,6 It is a relatively rare clinical condition, thus making it difficult to gather solid epidemiological studies, particularly with regards to its frequency.…”

“…1 Treatment is mainly conservative, however, the colon may become massively dilated and if not decompressed, the patient is at risks of perforation, peritonitis and death. 1,3,5,6 It is a relatively rare clinical condition, thus making it difficult to gather solid epidemiological studies, particularly with regards to its frequency. Until 1986 only 400cases had been reported.…”

“…1 The condition mainly affects the caecum and right colon [1][2][3] It is more common in the elderly and those with systemic illnesses. 2,4 In 50-60% of cases the preceding cause is trauma or surgical procedure, most commonly caesarean section.…”

Constipação intestinal em terapia intensiva

“…It was described in 1948 by William Ogilvie in two patients with colon paresis caused by retroperitoneum neoplasms with invasion of the celiac plexus. (29) Its incidence is not well established in literature. It is an important cause of morbidity and mortality in ICU patients, (30)(31) and in presence of intestinal perforation, mortality can exceed 50%.…”

Sickle Cell Disease-Induced Ogilvie’s Syndrome in a Child Treated Pharmacologically With Neostigmine: A Case Report.

“…Acute colonic pseudo-obstruction (ACPO) is also known as an Ogilvie's syndrome after Sir William H Ogilvie, in 1948, observed and reported the condition (Ogilvie, 1948). It is a poorly understood syndrome, characterized by symptoms, signs and radiological pattern of the large bowel obstruction with no evidence of mechanical obstruction (De Giorgio et al, 2001;Singh et al, 2005).…”