Ogilvie’s-Syndrome: A Rare but Real Postpartum Nightmare | OAJBS

Acute Colonic Pseudo-Obstruction (ACPO) is a rare however fatal postpartum emergency. This mini-review article will highlight some details from both surgical and aesthetic point of view. Sir William Ogilvie (British surgeon), first described the syndrome of colonic pseudo-obstruction in 1948 in 2 patients with celiac plexus tumors. His theory for the explanation of the syndrome was the sympathetic denervation of the colon [1]. However, Dudley in 1958 recognized the functional obstruction rather than mechanical and named it Acute Colonic Pseudo- Obstruction (ACPO). The exact etiology is unknown, however there are several theories. The main theory involves autonomic imbalance, probably augmented sympathetic over parasympathetic tone [5]. The increased sympathetic activity, dynamically dilates the proximal colon, whereas the reduced parasympathetic tone collapses the distal colon (functional obstruction). This theory is supported by the presence of a “cut-off sign” between the area of dilated &collapsed bowel around the splenic flexure resembling the transition zone between the vagal and sacral parasympathetic nerve supply. The syndrome has been associated with general disorders; severe trauma, sepsis, electrolyte disturbance, diabetes, Multiple Sclerosis (MS) and severe constipation. Postoperative ACPO was reported following total joint replacement, Coronary Artery Bypass Graft surgeries (CABG) and neurosurgery. Whereas obstetric causes included cesarean (the most common), obstetric hemorrhage, multiple pregnancies, and preterm labor. Some medications are found to cause ACPO as.....

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