Large Bowel Obstruction, Ogilvie Syndrome, and Stercoral Colitis: When Is Dilatation Pathologic? How Are These Conditions Managed?

  • Scott H. PasichowEmail author
  • Angela F. Jarman


Large bowel obstruction is a mechanical blockage of the colon causing abdominal distention and decreased bowel function. It is defined as 6 cm of colonic dilation or 9 cm of cecal dilation. Ogilvie syndrome, or colonic pseudo-obstruction, is a large bowel obstruction without an anatomic lesion, while stercoral colitis is dilation from impacted stool causing bowel wall inflammation. Although mechanical obstructions and volvulus generally require surgical management, pseudo-obstruction without 12 cm or more of dilation, peritonitis, or severe pain can often be managed conservatively with aggressive bowel regimens. Neostigmine, a cholinesterase inhibitor, is shown to be up to 90% effective in Ogilvie syndrome cases when conservative therapies fail. When pharmacotherapies are unsuccessful, colonoscopic decompression or surgery may be needed.


Large bowel obstruction Ogilvie syndrome Stercoral colitis Neostigmine Pseudo-obstruction 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Emergency MedicineAlpert School of Medicine of Brown UniversityProvidenceUSA

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