OGILVIE’S SYNDROME

Ogilvie syndrome is a rare, acquired disorder characterized by abnormalities affecting the involuntary, rhythmic muscular contractions (peristalsis) within the colon. Peristalsis propels food and other material through the digestive system through the coordination of muscles, nerves and hormones. The colon is often significantly widened.

Sir William Heneage Ogilvie in 1948. Also called as colonic pseudo-obstruction caecum more than 10 cm in diameter. Splenic flexure and descending colon goes for functional atony.

SYMPTOMS OF OGILVIE’S SYNDROME

• Nausea
• Vomiting
• abdominal bloating or swelling
• Constipation
• Severe colonic ileus occurs without any mechanical obstruction.
• Tympanic, nontender, distended abdomen and bowel sounds will be normally present

CAUSE OF OGILVIE’S SYNDROME

Due to sacral parasympathetic nerve dysfunction.

Commonly seen in right and transverse colon.

Due to sacral parasympathetic malfunctioning, there is atony of descending colon causing functional obstruction.

It is seen in: –

• Scleroderma, SLE, dermatomyositis
• Chaga’s disease
• Myotonic dystrophy
• multiple sclerosis
• Neuropathies
• Myopathies
• Hypothyroidism
• diabetes mellitus
• CRF
• renal transplantation
• Poisoning, sepsis, hypoxia
• Radiotherapy
• pelvic trauma, shock, stroke – Septicaemia,

INVESTIGATIONS OF OGILVIE’S SYNDROME

• Plain X-ray abdomen shows dilatation of colon.
• Barium enema
• colonoscopy
• CT abdomen

TREATMENT OF OGILVIE’S SYNDROME

• Mainly conservative.
• Motility enhancing drugs like neostigmine and erythromycin are used.
• Ryle’s tube aspiration.
• Flatus tube insertion.