Post cesarean section acute colonic pseudo-obstruction (Ogilvie syndrome): A case report

Introduction: Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie syndrome is a condition characterized by massive colonic distension in the absence of mechanical obstruction. In female patients, it has an association with cesarean section. Ogilvie syndrome is a rare and therefore infrequently reported condition. However, it can be associated with serious morbidity and mortality. Case Report: A 33-year-old female developed Ogilvie syndrome quickly after an emergency cesarean section. She was managed conservatively with a prokinetic (drug which enhances gastrointestinal motility) following confirmation of an acute colonic pseudo-obstruction on computed tomography scan and she made a full recovery. Conclusion: Mortality rates from Ogilvie syndrome are quoted as between 36–50% when bowel perforation or ischemia develops. Clinicians should be aware that ACPO can complicate cesarean sections. Mechanical obstruction should be excluded by radiological imaging including X-ray and computed tomography scan. A prompt management plan should be in place and we suggest a logarithm to manage such cases. This case illustrates the W. Carlino1, H. Hanna1, O. Eskandar1 Affiliations: 1Department of Obstetrics and Gynecology, North Devon District Hospital, Barnstaple, Devon, EX31 4JB. Corresponding Author: Mr. Osama Eskandar FRCOG MFSRH, Department of Obstetrics and Gynecology, North Devon District Hospital, Barnstaple, Devon, EX31 4JB, UK, Email: [email protected] Received: 03 May 2017 Accepted: 12 June 2017 Published: 11 July 2017 importance of early diagnosis and management as well as effective communication between the surgical and obstetric team.