Association Between Acute Colonic Pseudo-Obstruction (Ogilvie Syndrome) And Nimodipine Use. Case Series And Comprehensive Review

Background:Nimodipine is a calcium channel blocker indicated for the management of patients with aneurysmal subarachnoid hemorrhage (SAH). Oral nimodipine has rarely been implicated in the development of acute colonic pseudo-obstruction in patients treated for SAH. Nimodipine acts by inhibiting the transmembrane influx of calcium ions essential for the excitation-contraction coupling process of smooth muscle cells. We thought that its mechanism of action could predispose patients to develop acute colonic pseudo-obstruction (Ogilvie syndrome). The purpose of this study was to revise the existing literature concerning the association between acute colonic pseudo-obstruction and nimodipine use in patients with SAH.Methods:Two patients with aneurysmal SAH who received oral nimodipine and developed Ogilvie syndrome were discussed. All previously published cases of aneurysmal SAH associated with acute colonic pseudo-obstruction were reviewed. Conclusion:This report linking the oral use of nimodipine with Ogilvie syndrome may further support the association of this disease with nimodipine use during the treatment of patients with aneurysmal SAH.

Ogilvie Syndrome Following Caesarean Section: A Case Report

Background. Ogilvie syndrome is a rare postpartum complication. It is characterized by an acute colonic pseudo-obstruction which occurs in the absence of a mechanical cause. Early detection of the diagnosis is essential to avoid cecal perforation. Case report. We report a case of Ogilvie syndrome following caesarean section in a 39-year-old woman (gravida 2, para 2) with a history of secondary infertility 10 years ago due to tubal stenosis and subserous fibroma, which led to the indication for cesarean section in second pregnancy at 39 weeks of gestation. Three days after cesarean section, the patient presented with significant abdominal distension and tenderness, vomiting, weakness, and nausea; an abdominal X-ray showed cecal distension. Abdominal computed tomography scan with intravenous contrast revealed distension of the ascending and transverse colon with air-fluid levels but without transitional mechanical obstruction. The patient was successfully treated. Conclusions. Ogilvie syndrome is a rare but serious complication that should be considered in fit young patients who present with pain, severe abdominal distension and failure to pass flatus after caesarean section.

Ogilvie syndrome (acute colon pseudo-obstruction) in surgical practice (review)

The aim of the review was to describe the evolution of scientific ideas about the syndrome of pseudo-obstruction of the large intestine (Ogilvie syndrome), taking into account the etiopathogenesis, clinical manifestations, the incidence of the disease, the state-of-art in diagnosis and treatment. The paper presents an analysis of the literature on the pseudoobstruction of the colon (Ogilvie syndrome) – the acute dilatation of the colon in the absence of any mechanical obstruction. The essence of the concept, the correctness of the notation, definitive criteria, terminology, pathophysiological and pathogenetic aspects of the disease according to the literature are described. The diagnostic and treatment algorithms are correctly described with an assessment of their effectiveness in accordance with the principles of evidence-based medicine. Despite the large number of publications devoted to Ogilvie syndrome and the increased awareness of doctors of various specialties on this pathology, its diagnostics is still difficult and often untimely.