ABSTRACT
Sir Ogilvie's initial description of the disease process proposed three different possibilities as to the cause of the signs and symptoms of colonic obstruction without any obstruction or colonic abnormality at surgery. The theories were that the “tumor” stimulated the parasympathetic supply to the colon, or stimulated peristalsis, or that malignant invasion interrupted the sympathetic supply to the large intestine. The diagnosis of Ogilvie syndrome classically starts with a clinical picture of obstipation and increasing gaseous abdominal distention. All patients with suspected Ogilvie syndrome should have an acute low colorectal mechanical obstruction ruled out. Ogilvie syndrome, or acute colonic pseudo-obstruction, is a syndrome marked by massive colonic dilation without mechanical obstruction. Treatment begins by allowing nothing by mouth, nasogastric decompression, correction of electrolyte abnormalities, and removal of offending agents. Colonoscopic decompression as a treatment modality surfaced in the late 1970s when surgical therapy was consistently showing a high mortality rate of greater than 50%.
