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Archives of Gynecology and Obstetrics

, Volume 300, Issue 1, pp 117–126 | Cite as

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

  • Clemens B. TempferEmail author
  • Askin Dogan
  • Ziad Hilal
  • Günther A. RezniczekEmail author
General Gynecology
  • 49 Downloads

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.

Keywords

Ogilvie’s syndrome Pseudo-obstruction Colon dilatation Bowel decompression Gynecology Surgical complication 

Abbreviations

OS

Ogilvie’s syndrome

MRT

Magnetic resonance tomography

CT

Computed tomography

POD

Postoperative day

NPO

Nil per os

CTCAE

Common Terminology Criteria for Adverse Events

Notes

Author contributions

CBT, AD and ZH collected data and wrote the manuscript. GR analyzed the data and contributed to writing the manuscript. All authors participated in discussion and revision of the manuscript.

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethics approval

Not applicable.

Informed consent

Not applicable.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyRuhr-Universität Bochum—Marien Hospital HerneHerneGermany

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