title: Ogilvie's syndrome in the postcesarean section patient.
abstract: Two cases of colonic pseudo-obstruction (the so-called Ogilvie's syndrome) are reported. Both patients were in the immediate postcesarean section puerperium. The importance of early diagnosis in these cases is stressed, because this complication has a high mortality rate, frequently in relation to delayed diagnosis and treatment. One patient was successfully treated with conservative measures because diagnosis was made early. A plain X-ray abdominal film which shows cecum dilatation, with or without ascending and transverse colon dilatation, and no distal air, makes the diagnosis. A cecum diameter of 9 cm or more is a surgical indication, because the possibility of wall perforation is high. Surgical techniques are: puncture decompression or cecostomy. When cecum diameter is less than 9 cm, non-surgical measures (nasogastric suction, correction of any fluid and electrolytic imbalance, and maybe a flatus tube) are indicated. Observation through repeated X-ray abdominal films shows when the surgical indication appears: (1) failure of the conservative treatment (cecal distension continues or increases); or (2) cecal perforation is documented.
authors.affiliation: Department of Gynecology and Obstetrics, Hospital Central Militar, Mexico City, D.F., Mexico.
authors.forename: R
authors.initials: R
authors.lastname: Rodriguez-Ballesteros
authors.forename: A
authors.initials: A
authors.lastname: Torres-Bautista
authors.forename: F
authors.initials: F
authors.lastname: Torres-Valadez
authors.forename: J A
authors.initials: JA
authors.lastname: Ruiz-Moreno
mesh_terms: D000328:Adult; D002585:Cesarean Section; D003112:Colonic Pseudo-Obstruction / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000209:etiology*; D011183:Postoperative Complications; D011247:Pregnancy