Ogilvie's syndrome in the postcesarean section patient.
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.
Rodriguez-Ballesteros
R
R
Department of Gynecology and Obstetrics, Hospital Central Militar, Mexico City, D.F., Mexico.
Torres-Bautista
A
A
Torres-Valadez
F
F
Ruiz-Moreno
J A
JA
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