Ogilvie's syndrome after pediatric spinal deformity surgery: successful treatment with neostigmine

2014 ◽  
Vol 14 (3) ◽  
pp. 255-258 ◽  
Author(s):  
Kristopher G. Hooten ◽  
Seth F. Oliveria ◽  
Shawn D. Larson ◽  
David W. Pincus
Keyword(s):  
Spinal Deformity ◽  
Early Recognition ◽  
Bowel Perforation ◽  
Deformity Correction ◽  
Tethered Cord ◽  
Abdominal Distension ◽  
Ogilvie's Syndrome ◽  
Ogilvie’S Syndrome ◽  
Adynamic Ileus ◽  
Spinal Deformity Surgery

Ogilvie's syndrome is a rare and potentially fatal disease that can easily be mistaken for postoperative ileus. Also known as acute colonic pseudo-obstruction, early recognition and diagnosis of the syndrome allows for treatment prior to bowel perforation and requisite abdominal surgery. The authors report a case of Ogilvie's syndrome following spinal deformity correction and tethered cord release in an adolescent who presented with acute abdominal distension, nausea, and vomiting on postoperative Day 0. The patient was initially diagnosed with adynamic ileus and treated conservatively with bowel rest, reduction in narcotic dosage, and a regimen of stool softeners, laxatives, and enemas. Despite this treatment, her clinical course failed to improve, and she demonstrated significant colonic distension radiographically. Intravenous neostigmine was administered as a bolus with a rapid and dramatic response. This case is the first reported instance of neostigmine use for Ogilvie's syndrome treatment following a pediatric neurosurgical operation.

Ogilvie's syndrome presented with delirium in an older lady with corticobasal syndrome

2021 ◽  
pp. 1-3
Author(s):  
Feyza Mutlay ◽  
Derya Kaya ◽  
Ahmet Turan Isik
Keyword(s):  
Palliative Care ◽  
Health Care Professionals ◽  
Colonic Obstruction ◽  
Holistic Approach ◽  
Abdominal Distension ◽  
Corticobasal Syndrome ◽  
Ogilvie's Syndrome ◽  
Geriatric Population ◽  
Ogilvie’S Syndrome ◽  
Neurological Illnesses

Abstract Objective Corticobasal syndrome (CBS) is one of an atypical parkinsonian syndromes characterized by extrapyramidal features as well as cortical involvement signs. A variety of factors may lead to delirium in older adults with chronic progressive life-limiting neurological illnesses like CBS. Ogilvie's syndrome (OS) is an acute colonic pseudo-obstruction in which abdominal distension, nausea, vomiting, and constipation can be seen. We report a case of OS identified as the underlying possible cause of delirium in an 80-year-old woman with CBS. We also discuss the importance of holistic approach which is essential to manage the underlying cause and to preserve the quality of life in particular for the frail geriatric population who potentially needs palliative care or already benefits from palliative care. Method An older patient with CBS presented with symptoms similar to that of acute colonic obstruction and subsequently developed delirium. The patient was found to have colonic pseudo-obstruction (OS). Result Neostigmin infusion was therefore given to treat it and delirium was resolved. Significance of results To the best of our knowledge, clinical manifestation of delirium as OS in a patient with CBS has not been previously reported. OS may be superimposed to CBS in older patients, and OS in such patients may play a role as a precipitating factor for the development of delirium. Given the fact that CBS is progressive and rare neurodegenerative disease and almost all of these patients need palliative care, eventually, health-care professionals, especially in palliative care, should be aware of distinctive challenges of life-limiting chronic neurological illnesses, such as conditions that may lead to the development of acute colonic pseudo-obstruction because the rapid treatment of them prevents the use of potentially harmful drugs, surgical procedures, or inappropriate interventions.

A Critical Analysis of Sagittal Plane Deformity Correction with Minimally Invasive Adult Spinal Deformity Surgery: A Two-Year Follow-Up Study

2015 ◽  
Vol 15 (10) ◽  
pp. S126-S127
Author(s):  
International Spine Study Group ◽  
Gregory M. Mundis ◽  
Jay D. Turner ◽  
Vedat Deviren ◽  
Juan S. Uribe ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Spinal Deformity ◽  
Critical Analysis ◽  
Sagittal Plane ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Follow Up Study ◽  
Spinal Deformity Surgery ◽  
Plane Deformity

scholarly journals Use of Aldosterone Antagonist to Treat Diarrhea and Hypokalemia of Ogilvie’s Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Pradhum Ram ◽  
Abhinav Goyal ◽  
Marvin Lu ◽  
Joshua Sloan ◽  
William McElhaugh
Keyword(s):  
Marked Improvement ◽  
Colonic Mucosa ◽  
Abdominal Distension ◽  
Bk Channels ◽  
Watery Diarrhea ◽  
Ogilvie's Syndrome ◽  
High Potassium ◽  
Ogilvie’S Syndrome ◽  
Aldosterone Antagonist ◽  
Neck Fracture

Ogilvie’s syndrome (OS) is a functional obstruction of the bowel due to an autonomic imbalance. It often presents with diarrhea and is associated with hypokalemia. We present a case of a 70-year-old male who developed severe abdominal distension, watery diarrhea, and persistent hypokalemia status after left hip arthroplasty after suffering from a femoral neck fracture due to a fall and was diagnosed with OS. The persistent hypokalemia was slow to improve despite aggressive repletion because of the high potassium losses in the stool. This is most likely mediated through the increased expression of BK channels in the colonic mucosa. Aldosterone is theorized to have a role in the regulation of BK channels. Spironolactone was subsequently given and resulted in marked improvement of the diarrhea and hypokalemia. Thus, this case suggests a novel therapeutic approach for the treatment of Ogilvie’s syndrome-associated diarrhea and hypokalemia.

Amitraz: an unusual aetiology of Ogilvie's syndrome

2005 ◽  
Vol 24 (9) ◽  
pp. 481-483 ◽  
Author(s):  
Sahin Aslan ◽  
Fatih Bilge ◽  
Bulent Aydinli ◽  
Tarik Ocak ◽  
Mustafa Uzkeser ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Gastric Lavage ◽  
Vital Signs ◽  
Abdominal Distension ◽  
Clinical Findings ◽  
Fluid Replacement ◽  
Supportive Treatment ◽  
Ogilvie's Syndrome ◽  
Ogilvie’S Syndrome ◽  
The Third

Amitraz is an insecticide/acaricide of formamidine pesticides used worldwide for ectoparasites in animals. Because of its widespread use, amitraz poisoning is frequently encountered in Turkey. Case report: A 36-year-old, comatose female was admitted to the hospital. Although it was stated that she had taken a glass of water containing amitraz, the exact volume of the substance was unknown. On admission, her Glasgow Coma Scale score was 10/15. Clinical findings were vomiting, miosis, bradycardia and hypotension. The patient's vital signs were body temperature 37.28C, pulse 54 bpm, blood pressure 80/50 mmHg and pulse-oximetry 84%. Supportive treatment consisting of oxygen, fluid replacement and gastric lavage, activated charcoal and atropine was administered. On the second day, signs of Ogilvie's syndrome characterized by severe tenderness, distension and pain in the abdomen were seen. On the third day, the patient's condition improved except for abdominal distension and pain, inability to pass faeces or flatus through the anus. Although continuous nasogastric tube decompression was performed, her complaints were not resolved completely. Neostigmine was administered on the fourth day. On the fifth day, abdominal pain and distension were decreased, and stool passage began. She had a complete clinical and laboratory improvement, which warranted her discharge on the seventh day of admission.

scholarly journals Neuromonitoring During Surgery for Paediatric Spinal Deformity in Canada (2007)

2009 ◽  
Vol 36 (1) ◽  
pp. 47-50 ◽  
Author(s):  
Jonathan Norton ◽  
Douglas Hedden
Keyword(s):  
Spinal Deformity ◽  
Motor Evoked Potentials ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Standard Of Care ◽  
National Standards ◽  
Spinal Deformity Surgery ◽  
Correction Surgery ◽  
Training Programmes ◽  
Spinal Cord Function

Background:Neuromonitoring during paediatric (and adult) spinal deformity surgery helps to reduce the risk of both permanent and short term neurological damage. A shortage of neurophysiologists and technicians limits the availability of this service. Not all surgeons believe neuromonitoring offers neuroprotection during spinal surgery. This study aimed to document the degree to which paediatric patients undergoing spinal deformity correction surgery have their spinal cord function monitored.Methods:A questionnaire was sent electronically to all of the surgical members of the Canadian Paediatric Spinal Deformity Study Group.Results:Results were received from 9/9 centres indicating that monitoring was performed in 7/9 centres, with one further centre awaiting staffing. Whilst half of those centres that do monitor only monitor sensory and motor evoked potentials, the remaining centres also use EMG and EEG to assess the state of the patient intraoperatively.Conclusions:Despite a shortage of staff, most paediatric spinal deformity surgeons in Canada who wish to, are able to neurophysiologically monitor their surgical cases. Neuromonitoring appears to be becoming a standard of care, at least for paediatric spinal deformity surgery. There is an urgent need for the establishment of national standards for both technologists and interpreters, as well as training programmes for both these groups.

Idiopathic intracranial hypertension following spinal deformity surgery in children

2011 ◽  
Vol 31 (4) ◽  
pp. E20 ◽  
Author(s):  
Justin Kunes ◽  
George H. Thompson ◽  
Sunil Manjila ◽  
Connie Poe-Kochert ◽  
Alan R. Cohen
Keyword(s):  
Intracranial Hypertension ◽  
Spinal Deformity ◽  
Idiopathic Intracranial Hypertension ◽  
Spinal Instrumentation ◽  
Deformity Correction ◽  
Aminocaproic Acid ◽  
Orthopedic Surgeons ◽  
Estimated Blood Loss ◽  
Spinal Deformity Surgery ◽  
Venous Outflow Obstruction

Idiopathic intracranial hypertension (IIH) after pediatric spinal deformity surgery has not been previously reported. The authors conducted a retrospective analysis of more than 1500 pediatric spinal surgeries performed between 1992 and 2011. From their analysis, they report on 3 adolescent patients who underwent uncomplicated segmental spinal instrumentation for pediatric spinal deformity correction and subsequently developed features of IIH. The common variables in these 3 patients were adolescent age, spinal deformity, being overweight, symptom onset within 2 weeks postoperatively, significant estimated blood loss, and intraoperative use of ε–aminocaproic acid (antifibrinolytic) injection. The authors postulate that the development of IIH could be the result of venous outflow obstruction due to derangement of the epidural venous plexus during surgery. The use of ε–aminocaproic acid could potentially have the risk of causing IIH, probably mediated through hyperfibrinogenemia, although there have not been published cases in the neurosurgical, orthopedic, cardiac, or general surgical literature. Idiopathic intracranial hypertension after spinal deformity correction is a condition that should be recognized by neurosurgeons and orthopedic surgeons, because appropriate intervention with early medical therapy can lead to a satisfactory clinical outcome.

scholarly journals Endoscopic Colonic Decompression

1990 ◽  
Vol 4 (9) ◽  
pp. 542-545 ◽  
Author(s):  
Norman E Marcon
Keyword(s):  
Large Intestine ◽  
Early Recognition ◽  
Electrolyte Imbalance ◽  
Mechanical Obstruction ◽  
Ogilvie's Syndrome ◽  
Ogilvie’S Syndrome ◽  
Colonic Decompression ◽  
Colonoscopic Decompression

Colonic pseudo-obscruction, or Ogilvie's syndrome, is characterized by marked distension of the large intestine in the absence of mechanical obstruction. Etiology is unknown. Left untreated, it may lead to perforation with a mortality of 46%. Reversible causes such as electrolyte imbalance, anricholinergic drugs, analgesics, steroids or hypothyro1d1sm should he excluded. Early recognition of pseudo-obstruction with institution of supportive means followed by colonoscopic decompression with rube placement should be successful in all cases.

scholarly journals The Accuracy of 3D Printing Assistance in the Spinal Deformity Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Po-Chen Chen ◽  
Chien-Chun Chang ◽  
Hsien-Te Chen ◽  
Chia-Yu Lin ◽  
Tsung-Yu Ho ◽  
...  
Keyword(s):  
3D Printing ◽  
Pedicle Screw ◽  
Spinal Deformity ◽  
Deformity Correction ◽  
Pedicle Screws ◽  
Evoke Potential ◽  
Printing Technology ◽  
3D Printing Technology ◽  
Spinal Deformity Surgery ◽  
Correction Surgery

Background. The pedicle screw is one of the main tools used in spinal deformity correction surgery. Robotic and navigated surgeries are usually used, and they provide superior accuracy in pedicle screw placement than free-hand and fluoroscopy-guided techniques. However, their high cost and space limitation are problematic. We provide a new solution using 3D printing technology to facilitate spinal deformity surgery. Methods. A workflow was developed to assist spinal deformity surgery using 3D printing technology. The trajectory and profile of pedicle screws were determined on the image system by the surgical team. The engineering team designed drill templates based on the bony surface anatomy and the trajectory of pedicle screws. Their effectiveness and safety were evaluated during a preoperative simulation surgery. The surgery consisted in making a pilot hole through the drill template on a computed tomography- (CT-) based, full-scale 3D spine model for every planned segment. Somatosensory evoke potential (SSEP) and motor evoke potential (MEP) were used for intraoperative neurophysiological monitoring. Postoperative CT was obtained 6 months after the correction surgery to confirm the screw accuracy. Results. From July 2015 to November 2016, we performed 10 spinal deformity surgeries with 3D printing technology assistance. In total, 173 pedicle screws were implanted using drill templates. No notable change in SSEP and MEP or neurologic deficit was noted. Based on postoperative CT scans, the acceptable rate was 97.1% (168/173). We recorded twelve pedicle screws with medial breach, six with lateral breach, and five with inferior breach. Medial breach (12/23) was the main type of penetration. Lateral breach occurred mostly in the concave side (5/6). Most penetrations occurred above the T8 level (69.6%, 16/23). Conclusion. 3D printing technology provides an effective alternative for spinal deformity surgery when expensive medical equipment, such as intraoperative navigation and robotic systems, is unavailable.

scholarly journals Negative Sagittal Balance Following Adult Spinal Deformity Surgery

2017 ◽  
Vol 8 (2) ◽  
pp. 149-155
Author(s):  
Robert K. Merrill ◽  
Jun S. Kim ◽  
Ian T. McNeill ◽  
Samuel C. Overley ◽  
James E. Dowdell ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Sagittal Balance ◽  
Adult Spinal Deformity ◽  
Univariate Analysis ◽  
Deformity Correction ◽  
Sagittal Vertical Axis ◽  
Spinal Deformity Surgery ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Study Design: Retrospective cohort study. Objective: Elucidate negative sagittal balance following adult spinal deformity surgery. Methods: We conducted a retrospective review of adult spinal deformity patients who underwent long fusion (>5 levels) to the sacrum by a single surgeon at a single institution between 2011 and 2015. Patients were divided into cohorts of postoperative sagittal vertical axis (SVA) <−10 mm, between −10 and +10 mm, or >+10 mm, denoted as groups 1, 2, and 3, respectively. Univariate analysis compared preoperative factors between the groups, and a multivariable logistic regression model was used to determine independent risk factors for developing a negative sagittal balance (SVA<−10 mm) following adult spinal deformity correction. Results: We reviewed 8 patients in group 1, 9 patients in group 2, and 25 patients in group 3. The average postoperative SVA for group 1, group 2, and group 3 were −30.99, +3.67, and +55.56 mm, respectively. There was a trend toward higher upper-instrumented vertebra (UIV) in group 1 (T2) compared with group 2 (T10) and group 3 (T9) ( P = .05). A trend toward lower preoperative SVA in groups 1 and 2 compared with group 3 was also seen (+53.36 vs +71.73 vs +122.80 mm) ( P = .06). Finally, we found a trend toward lower body mass index in group 1 compared with groups 2 and 3 (24.71 vs 25.92 vs 29.33 kg/m2) ( P = .07). Based on multivariable regression, higher UIV was found to be a statistically significant independent predictor for developing a postoperative negative sagittal balance of <−10 mm ( P = .02, odds ratio = 0.67). Conclusions: Our results demonstrate that a higher UIV may predispose patients undergoing adult spinal deformity correction to have a postoperative negative sagittal balance.

scholarly journals Reactivation of herpes simplex labialis following adult spine deformity correction surgery

2021 ◽  
Vol 12 ◽  
pp. 562
Author(s):  
Nitin Adsul ◽  
Idris Hamim ◽  
Mohan Banglore ◽  
Robert Lee
Keyword(s):  
Herpes Simplex ◽  
Spinal Deformity ◽  
Previous History ◽  
Deformity Correction ◽  
Spine Deformity ◽  
Spinal Deformity Surgery ◽  
History Of ◽  
Correction Surgery ◽  
Simplex Virus ◽  
Adult Spine

Background: A depressed host defense is a major contributor to the oral shedding of herpes simplex virus (HSV) type 1. Here, we present an instance in which herpes simplex labialis was reactivated following major spinal deformity surgery. Case Description: A 59-year-old female underwent spinal deformity correction for lumbar degenerative scoliosis. On postoperative days 2–3, she presented with pyrexia (38°C) and tachycardia (94/min); by day 5 she had multiple ulcers around her lips and was HSV IgG positive. She had a remote history of herpes simplex I infection 7 years previously. Once started on oral acyclovir, the lesions improved, and by day 15 postoperative, her pyrexia and all lesions completely resolved. Conclusion: HSV-1 should be suspected in patients with a previous history of HSV and postoperative pyrexia. Adequate prophylactic administration of acyclovir should result in resolution of these outbreaks, in this case, attributed to overly extensive spinal deformity surgery.

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