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Acute colonic pseudo-obstruction in a patient following total abdominal hysterectomy and bilateral salpingo-oophorectomy (Ogilvie syndrome)

Authors:

D. S. Weerasekera ,

Sir John Kotelawala Defence University, LK
About D. S.
Professor of Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology
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W. D. D. de Silva,

Sir John Kotelawala Defence University, LK
About W. D. D.
Senior Lecturer in Surgery, Department of Surgery
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N. K. Rodrigo,

Sir John Kotelawala Defence University, LK
About N. K.
Senior Lecturer in Obstetrics and Gynaecology
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T. K. I. N. Nanayakkara

Kotelawala Defence University, LK
About T. K. I. N.
Medical Officer, Department of Obstetrics and Gynaecology, University Hospital
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Abstract

A 50-year-old woman underwent total abdominal hysterectomy and bilateral salphingo-oophorectomy for heavy menstrual bleeding due to a uterine fibroid. On second post-operative day she developed progressive abdominal distention, tachycardia, and fever. An intra-abdominal pathology was suspected and she was re-opened on the third postoperativeday. At laparotomy a distended colon was found with serosal tears due to distention with no distal colonic obstruction. Bowel decompression was done and a diagnosis of acute colonic pseudo-obstruction (ACPO) was made. Since her abdominal distention was persisting after the laparotomy she was treated with intravenous neostigmine. She responded immediately with passage of flatus and bowel opening. Subsequent recovery was uneventful. ACPO is a clinical entity characterized by severe colonic distention in the absence of mechanical obstruction. It can result in bowel ischaemia and perforation if left untreated. Therapeutic importance of neostigmine is discussed in the management ofthis potentially fatal condition.
How to Cite: Weerasekera, D.S., de Silva, W.D.D., Rodrigo, N.K. and Nanayakkara, T.K.I.N., 2020. Acute colonic pseudo-obstruction in a patient following total abdominal hysterectomy and bilateral salpingo-oophorectomy (Ogilvie syndrome). Sri Lanka Journal of Obstetrics and Gynaecology, 42(4), pp.157–160. DOI: http://doi.org/10.4038/sljog.v42i4.7970
Published on 31 Dec 2020.
Peer Reviewed

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