Ogilvie's syndrome after lower extremity arthroplasty.
OBJECTIVE
To alert surgeons who perform arthroplasty to the possibility of acute colonic pseudo-obstruction (Ogilvie's syndrome) after elective orthopedic procedures. To identify possible risk factors and emphasize the need for prompt recognition, careful monitoring and appropriate management so as to reduce morbidity and mortality.


METHODS
A case series.


METHODS
A university-affiliated hospital that is a major referral centre for orthopedic surgery.


METHODS
Four patients who had Ogilvie's syndrome after lower extremity arthroplasty. Of this group, 2 had primary hip arthroplasty, 1 had primary knee arthroplasty and 1 had revision hip arthroplasty.


METHODS
Morbidity and mortality.


RESULTS
In all 4 patients Ogilvie's syndrome was recognized late and required surgical intervention. Two patients died as a result of postoperative complications.


CONCLUSIONS
Our case series identified increasing age, immobility and patient-controlled narcotic analgesia as potential risk factors for Ogilvie's syndrome in the postoperative orthopedic patient. Prompt recognition and early consultation with frequent clinical and radiographic monitoring are necessary to avoid colonic perforation and its significant associated death rate.
elMaraghy
A W
AW
Division of Orthopedic Surgery, St. Michael's Hospital, Toronto, Ont.
Schemitsch
E H
EH
Burnstein
M J
MJ
Waddell
J P
JP
D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D003112:Colonic Pseudo-Obstruction / Q000000981:diagnostic imaging / Q000209:etiology*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography