Ogilvie’s syndrome is an acute dilatation of a part or all of the
colon and rectum without mechanical obstruction. The diagnosis is based on
computed tomography (CT) that excludes organic or functional
colonic obstruction and?ensures the detection of signs of severity. Rapid
diagnosis leads to conservative measures and the resolution of obstruction.
Delays in diagnosis can lead to complications imposing a surgical treatment and
increased mortality rate. We report the case of a 52 years old woman with Parkinson’s disease, who
presented Ogilvie’s syndrome. The initial assessment did not show signs of
severity, so medical treatment was introduced but without improvement; for this reason, the
surgical procedure was indicated as a cecostomy. There are several theories
that explain the pathophysiology of Ogilvie’s syndrome; the most likely is the
dysfunction of innervation of the colon which is due to Parkinson’s disease in
our case. The diagnosis is based on computed tomography. The treatment is
pharmacologic, conservative or surgical depending on the severity of the
disease and its evolution.
References
[1]
Ross, S.W., Oommen, B., Wormer, B.A., et al. (2016) Acute Colonic Pseudo-Obstruction: Defining the Epidemiology, Treatment, and Adverse Outcomes of Ogilvie’s Syndrome. The American Surgeon, 82, 102-111.
[2]
Ogilvie, H. (1948) Large-Intestine Colic Due to Sympathetic Deprivation: A New Clinical Syndrome. British Medical Journal, 2, 671-673.
https://doi.org/10.1136/bmj.2.4579.671
[3]
Shera, I.A., Vyas, A., Bhat, M.S. and Yousuf, Q. (2014) Unusual Case of Hashimoto’s Encephalopathy and Pseudo-Obstruction in a Patient with Undiagnosed Hypothyroidism: A Case Report. Journal of Medical Case Reports, 8, 296.
https://doi.org/10.1186/1752-1947-8-296
[4]
Barth, X., Chenet, P., Hoen, J.P., et al. (1991) La colectasie aigue idiopathique ou syndrome d’ogilvie: A propos de 43 observations. Lyon chirurgical, 87, 230-236.
[5]
Wrenn, S.M., Parsons, C.S., Yang, M. and Malhotra, A.K. (2017) Acute Large Bowel Pseudo-Obstruction Due to Atrophic Visceral Myopathy: A Case Report. International Journal of Surgery Case Reports, 33, 79-83.
https://doi.org/10.1016/j.ijscr.2017.02.040
[6]
Jayaram, P., Mohan, M., Lindow, S. and Konje, J. (2017) Postpartum Acute Colonic Pseudo-Obstruction (Ogilvie’s Syndrome): A Systematic Review of Case Reports and Case Series. European Journal of Obstetrics & Gynecology and Reproductive Biology, 214, 145-149. https://doi.org/10.1016/j.ejogrb.2017.04.028
[7]
Marinella, M.A. (1997) Acute Colonic Pseudo-Obstruction Complicated by Cecal Perforation in a Patient with Parkinson’s Disease. The Southern Medical Journal, 90, 1023-1026. https://doi.org/10.1097/00007611-199710000-00009
[8]
Motiaa, Y., Abdouni, A., Rais, S., et al. (2017) Acute Colonic Pseudo-Obstruction Associated with Parkinson’s Disease. Gastroenterology & Hepatology: Open Access, 8, Article ID: 00277. https://doi.org/10.15406/ghoa.2017.08.00277
[9]
Cersosimo, M.G. and Benarroch, E.E. (2012) Pathological Correlates of Gastrointestinal Dysfunction in Parkinson’s Disease. Neurobiology of Disease, 46, 559-564.
https://doi.org/10.1016/j.nbd.2011.10.014
[10]
Poirier, A.A., Aubé, B., Coté, M., et al. (2016) Gastrointestinal Dysfunctions in Parkinson’s Disease: Symptoms and Treatments. Parkinson’s Disease, 2016, Article ID: 6762528. https://doi.org/10.1155/2016/6762528
[11]
Braak, H., De Vos, R.A., Bohl, J. and Del Tredici, L. (2006) Gastricalpha Alpha-Synuclein Immunoreactive Inclusions in Meissner’s and Auerbach’s Plexuses in Cases Staged for Parkinson’s Disease-Related Brain Pathology. Neuroscience Letters, 396, 67-72.
https://doi.org/10.1016/j.neulet.2005.11.012
[12]
Hawkes, C.H., Del Tredici, K. and Braak, H. (2007) Parkinson’s Disease: A Dual-Hit Hypothesis. Neuropathology and Applied Neurobiology, 33, 599-614.
https://doi.org/10.1111/j.1365-2990.2007.00874.x
[13]
Pan Montojo, F., Anichtchik, O., Dening, Y., et al. (2010) Progression of Parkinson’s Disease Pathology Is Reproduced by Intragastric Administration of Rotenone in Mice. PLoS ONE, 5, e8762. https://doi.org/10.1038/npre.2010.3352.3
[14]
Godfrey, E.M., Addey, H.C. and Shaw, A.S. (2009) The Use of Computed Tomo-Graphy in the Detection and Characterisation of Large Bowel Obstruction. New Zealand Medical Journal, 122, 57-73.
[15]
Choi, J.S., Lim, J.S., Kim, H., et al. (2008) Colonic Pseudo-Obstruction: CT Findings. American Journal of Roentgenology, 190, 1521-1526.
https://doi.org/10.2214/AJR.07.3159
[16]
Pereira, P., Djeudji, F., Leduc, P., et al. (2015) Ogilvie’s Syndrome—Acute Colonic Pseudo-Obstruction. Journal of Visceral Surgery, 152, 99-105.
https://doi.org/10.1016/j.jviscsurg.2015.02.004
Harrison, M.E., Anderson, A.M., Appalaneni, V., et al. (2010) The Role of Endoscopy in the Management of Patients with Known and Suspected Colonic Obstruction and Pseudo-Obstruction. Gastrointestinal Endoscopy, 71, 669-679.
https://doi.org/10.1016/j.gie.2009.11.027
[19]
Jain, A. and Vargas, H.D. (2012) Advances and Challenges in the Management of Acute Colonic Pseudo-Obstruction (Ogilvie Syndrome). Clinics in Colon and Rectal Surgery, 25, 37-45. https://doi.org/10.1055/s-0032-1301758
[20]
Smedley, L.W., Foster, D.B., Barthol, C.A., et al. (2018) Safety and Efficacy of Intermittent Bolus and Continuous Infusion Neostigmine for Acute Colonic Pseudo-Obstruction. Journal of Intensive Care Medicine.
https://doi.org/10.1177/0885066618809010