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Colonic Ileus and Ogilvie Syndrome
Michael P. Federle, MD, FACR
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Ogilvie syndrome, colonic pseudoobstruction, pseudomegacolon, adult megacolon, adynamic ileus, functional obstruction, idiopathic large bowel obstruction
          • Definitions

            • Dilation of colon with obstructive symptoms without mechanical obstruction in acute or chronic setting
              • Acute: Reversible, occurring with severe medical illness and major surgeries
              • Chronic: Constipation, no etiology for ileus, and repeated obstructive symptoms

          IMAGING

          • General Features

            • Imaging Recommendations

              • Radiographic Findings

                • CT Findings

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Microscopic Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Image Interpretation Pearls

                                  Selected References

                                  1. Gabbard SL et al: Chronic intestinal pseudo-obstruction. Nutr Clin Pract. 28(3):307-16, 2013
                                  2. Doorly MG et al: Pathogenesis and clinical and economic consequences of postoperative ileus. Surg Clin North Am. 92(2):259-72, viii, 2012
                                  3. Elsner JL et al: Intravenous neostigmine for postoperative acute colonic pseudo-obstruction. Ann Pharmacother. 46(3):430-5, 2012
                                  4. Tsirline VB et al: Colonoscopy is superior to neostigmine in the treatment of Ogilvie's syndrome. Am J Surg. 204(6):849-55; discussion 855, 2012
                                  5. De Giorgio R et al: Acute colonic pseudo-obstruction. Br J Surg. 96(3):229-39, 2009
                                  6. Choi JS et al: Colonic pseudoobstruction: CT findings. AJR Am J Roentgenol. 190(6):1521-6, 2008
                                  7. Grassi R et al: Ogilvie's syndrome (acute colonic pseudo-obstruction): review of the literature and report of 6 additional cases. Radiol Med. 109(4):370-5, 2005
                                  8. Stieger DS et al: Acute colonic pseudoobstruction (Ogilvie's syndrome) in two patients receiving high dose clonidine for delirium tremens. Intensive Care Med. 23(7):780-2, 1997
                                  9. Vráblik V et al: [Pseudoobstruction syndrome of the large intestine (endoscopic therapy).] Vnitr Lek. 36(10):1002-4, 1990
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Imaging

                                    • Top Differential Diagnoses

                                      • Clinical Issues

                                        • Diagnostic Checklist

                                          TERMINOLOGY

                                          • Synonyms

                                            • Ogilvie syndrome, colonic pseudoobstruction, pseudomegacolon, adult megacolon, adynamic ileus, functional obstruction, idiopathic large bowel obstruction
                                          • Definitions

                                            • Dilation of colon with obstructive symptoms without mechanical obstruction in acute or chronic setting
                                              • Acute: Reversible, occurring with severe medical illness and major surgeries
                                              • Chronic: Constipation, no etiology for ileus, and repeated obstructive symptoms

                                          IMAGING

                                          • General Features

                                            • Imaging Recommendations

                                              • Radiographic Findings

                                                • CT Findings

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Microscopic Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Demographics

                                                            • Natural History & Prognosis

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Image Interpretation Pearls

                                                                  Selected References

                                                                  1. Gabbard SL et al: Chronic intestinal pseudo-obstruction. Nutr Clin Pract. 28(3):307-16, 2013
                                                                  2. Doorly MG et al: Pathogenesis and clinical and economic consequences of postoperative ileus. Surg Clin North Am. 92(2):259-72, viii, 2012
                                                                  3. Elsner JL et al: Intravenous neostigmine for postoperative acute colonic pseudo-obstruction. Ann Pharmacother. 46(3):430-5, 2012
                                                                  4. Tsirline VB et al: Colonoscopy is superior to neostigmine in the treatment of Ogilvie's syndrome. Am J Surg. 204(6):849-55; discussion 855, 2012
                                                                  5. De Giorgio R et al: Acute colonic pseudo-obstruction. Br J Surg. 96(3):229-39, 2009
                                                                  6. Choi JS et al: Colonic pseudoobstruction: CT findings. AJR Am J Roentgenol. 190(6):1521-6, 2008
                                                                  7. Grassi R et al: Ogilvie's syndrome (acute colonic pseudo-obstruction): review of the literature and report of 6 additional cases. Radiol Med. 109(4):370-5, 2005
                                                                  8. Stieger DS et al: Acute colonic pseudoobstruction (Ogilvie's syndrome) in two patients receiving high dose clonidine for delirium tremens. Intensive Care Med. 23(7):780-2, 1997
                                                                  9. Vráblik V et al: [Pseudoobstruction syndrome of the large intestine (endoscopic therapy).] Vnitr Lek. 36(10):1002-4, 1990