{"id":8216,"date":"2022-09-08T06:00:09","date_gmt":"2022-09-08T10:00:09","guid":{"rendered":"https:\/\/gastropedia.pub\/en\/?p=8216"},"modified":"2023-12-29T13:51:01","modified_gmt":"2023-12-29T18:51:01","slug":"treatment-of-colon-volvo-and-acute-colon-pseudo-obstruction-ogilvies-syndrome","status":"publish","type":[121],"link":"https:\/\/gastropedia.pub\/en\/surgery\/treatment-of-colon-volvo-and-acute-colon-pseudo-obstruction-ogilvies-syndrome\/","title":{"rendered":"Treatment of Colon Volvo and Acute Colon Pseudo-Obstruction (Ogilvie’s Syndrome)"},"content":{"rendered":"

Colon obstructions can be mechanical or non-mechanical and constitute about 25% of all intestinal obstructions. Among the mechanical causes<\/strong>, the most common are:<\/p>\n

    \n
  1. obstructive tumor in the colon or rectum (60%);<\/li>\n
  2. cicatricial stenosis from previous diverticulitis (10%);<\/li>\n
  3. colon volvulus (15 to 20%).<\/li>\n<\/ol>\n

    The colon volvulus is the twisting of a redundant segment of the colon in its mesentery that can lead to luminal occlusion of the twisted segment and ischemia by rotation of the mesocolon and, consequently, to perforation.<\/p>\n

    Although the colon volvulus can occur in any redundant segment, it most commonly involves the sigmoid (60%\u201375% of all cases) and cecum (25%\u201340% of all cases).<\/p>\n

    The sigmoid volvulus mainly occurs during the 6th to 8th decades of life, being more common in men, institutionalized patients, patients with chronic constipation, neuropsychological impairment or decompensated comorbidities. On the other hand, the cecal volvulus usually presents in younger patients and has a female predominance.<\/p>\n

    The acute pseudo-obstruction of the colon, or Ogilvie’s syndrome, is a non-mechanical functional cause of obstruction believed to be a consequence of the deregulation of the autonomic impulses of the colon’s innervation. There is great distension of the colon without an obstructive factor, but which can also evolve into ischemia and perforation. Clinical presentations vary according to the degree of distension, whether the ileocecal valve is competent or not, and the patient’s clinical condition. More commonly, Ogilvie’s syndrome affects elderly patients or patients hospitalized for unrelated reasons, including elective surgery, trauma, or treatment of an acute medical condition.<\/p>\n

    Here we present some recommendations from the guidelines of the American Society of Colorectal Surgery for the management of these cases.<\/p>\n

    Colon Volvulus<\/strong><\/h2>\n