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Archives of Gynecology and Obstetrics

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01-07-2019 | Laparotomy | General Gynecology

Acute colonic pseudoobstruction (Ogilvie’s syndrome) in gynecologic and obstetric patients: case report and systematic review of the literature

Authors: Clemens B. Tempfer, Askin Dogan, Ziad Hilal, Günther A. Rezniczek

Published in: Archives of Gynecology and Obstetrics | Issue 1/2019

Abstract

Background

Acute colonic pseudo-obstruction or Ogilvie’s syndrome (OS) is a rare form of postsurgical or posttraumatic complication. OS rarely occurs in the postoperative course of gynecologic and obstetric patients and is difficult to diagnose.

Case presentation

We present the case of an 83-years-old patient with carcinosarcoma of the uterus who developed OS with non-obstructive dilation of the right hemicolon and intraabdominal compression after total abdominal hysterectomy, omentectomy, and lymphadenectomy. Laparotomy with colonic decompression and abdominal dressing was performed. Subsequently, the patient developed pneumonia and peritonitis and died due to septic shock.

Systematic literature review

We identified 49 case reports and 10 case series describing 17 gynecologic (cervical cancer, n = 2; carcinosarcoma of the uterus, n = 1; benign gynecologic condition, n = 14) and 76 obstetric patients (cesarean section, n = 66; OS during pregnancy or after vaginal delivery, n = 10). Outcome data were available for 59 patients. First-line treatment was conservative in 22/59 (37%) cases, laparotomy with decompression or colon resection was performed in 20/59 (34%) cases, endoscopic decompression in 12/59 (20%) cases, and i.v. neostigmine in 4/59 (7%) cases. Resolution was achieved in 22/59 (37%) of patients. The most common second-line treatment was right hemicolectomy. Adverse events grade 3 and 4 were observed in 8/59 and 31/59 patients (together 66%), respectively, mortality was 3/59 (5%).

Conclusion

OS is a rare postoperative complication of gynecologic and obstetric patients with a good prognosis, but a high morbidity. Pregnancy seems to be a predisposing factor for OS. Conservative treatment is a successful first-line approach.

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Title: Acute colonic pseudoobstruction (Ogilvie’s syndrome) in gynecologic and obstetric patients: case report and systematic review of the literature
Authors: Clemens B. Tempfer
Askin Dogan
Ziad Hilal
Günther A. Rezniczek
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keywords: Laparotomy
Laparotomy
Sectio Ceasarea
Pregnancy
Sectio Caesarea
Published in: Archives of Gynecology and Obstetrics / Issue 1/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-019-05170-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Acute colonic pseudoobstruction (Ogilvie’s syndrome) in gynecologic and obstetric patients: case report and systematic review of the literature

Abstract

Background

Case presentation

Systematic literature review

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case presentation

Systematic literature review

Conclusion

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