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Case Report



Total colectomy with an end ileostomy in Ogilvie’s syndrome

Saul Jasam Ruiz Cereceres, Cesar Alberto Lopez Jaime, Carlos Tadeo Perzabal Avilez, Tanya Gisselle Zapata Arredondo, Aldo Gustavo Acosta Garcia, Anna Karina Soto Posada.


Abstract

Introduction. Ogilvie’s syndrome, also known as acute colonic pseudo-obstruction (ACPO), is a condition characterized by massive dilatation of the colon, particularly caecum and right hemi-colon without any mechanical obstruction.
Case report. This is a 50-year-old male patient with a history of chronic diseases including HIV, all under medical treatment and with a surgical history of supracondylar amputation 3 weeks ago. He went to the emergency room after presenting the absence of evacuations of 3 weeks of evolution after his hospital discharge due to amputation, accompanied by diffuse intermittent colic-type abdominal pain, as well as abdominal distension, nausea and vomiting in small quantities. A simple abdominal tomography was performed, with great distention of the right colon (11 cm), transverse colon with abundant gas and distention (10 cm), and descending colon and sigmoid with distention (7 cm) and abundant coprostasis.
Medical treatment is started without clinical improvement, presenting greater abdominal pain predominantly on the right and elevated white blood cells, for which colonic perforation is suspected and it is decided to perform exploratory laparotomy, with total colectomy and terminal ileostomy.
Conclusion. Ogilvie's syndrome is rare and normally responds to medical treatment, however, when suspected of perforation or failure of medical treatment, it is decided to perform colonic bypass surgery, such as a colostomy or in some cases hemicolectomies or total colectomy, depending on of each patient, their comorbidities and their current clinical status.

Key words: Ogilvie’s Syndrome, bowel obstruction, pseudo-colonic obstruction, treatment






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