Ogilvie’s Syndrome after Cesarean Section: Case Report in Saudi Arabia and Management Approach

Abstract

Background Acute colonic pseudoobstruction or Ogilvie's syndrome is a rare entity that is characterized by acute dilatation of the colon without any mechanical obstruction. It is usually associated with medical disease or surgery and rarely occurs spontaneously. If not diagnosed early, Ogilvie's syndrome may cause bowel ischemia and perforation. Case A G7P4+2, 40-year-old woman, who is a known case of gestational diabetes mellitus during her current pregnancy, four previous cesarean sections, two early pregnancy losses at six-week gestation, and hypothyroidism, underwent uncomplicated elective cesarean section, after which she complained of abdominal distention. 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. This case report reviews the clinical characteristics, diagnostic methods, and management of Ogilvie's syndrome. Moreover, we suggest a management approach to help in early diagnosis and prompt management to improve the outcome of this potentially serious condition.

A Rare and Potentially Mortal Post-Caesarean Complication: Ogilvie's Syndrome-Acute Colonic Pseudo-Obstruction

“…There is limited information in the literature about the development of Ogilvie's syndrome after caesarean section. [4][5][6] The usual presentation is colicky abdominal pain, distension, nausea, and vomiting ranging from complete obstipation to intermittent flatus and stool discharge. Gross distension of colon (≥ 8-10 cm) usually in caecum and ascending colon on abdominal X-ray film is the hallmark of diagnosis besides air-fluid levels.…”

The Role of Increasing Serum C-reactive Protein Level in Diagnosis of Post-surgery Small Bowel Pseudo-obstruction: A Case Report

“…The symptoms or signs of ACPO, which are related to bowel obstruction, include abdominal pain or tenderness, nausea and/or vomiting, constipation, and fever. Early diagnosis of ACPO is critical because of its subsequent morbidity, including bowel ischemia, necrosis and perforation, and colon torsion; its mortality rate can also reach 50% (3,4).…”

Acute Colonic Pseudo-obstruction (Adynamic Ileus) after Cesarean Section: A Case Series

“…The first and third patients were an elective CS procedure, while the second patient was an emergency CS procedure.Cho et al mentioned that pregnant women with chronic constipation, administering constipation therapy during pregnancy, and administering enemas before CS reduce the risk of post-SC ileus12 . Based on previous publications, postoperative ileus is treated with supportive management including: fasting, correction of fluid and electrolyte disturbances, early mobilization of the patient, NGT insertion, enema administration, laxatives, discontinuation of drugs that interfere with colonic motility such as opioid analgesics anticholinergic and calcium antagonists, and use neostigmine (prostigmine).1,2,[12][13][14][15][16][17] Some agents are said to work as prokinetic agents to treat postoperative ileus, Cisapride is a serotonin agonist that facilitates the release of acetylcholine, however its use in some countries has been withdrawn because of its cardiac side effects Ceruletide is a synthetic peptide that increases bowel movements…”