[Ogilvie syndrome after Cesarean section].
BACKGROUND
Ogilvie's syndrome, acute pseudo-obstruction of the colon, can lead to perforation of the caecum and death. The syndrome is not well known and diagnosis can be difficult to make in time.


METHODS
We analysed seven cases of Ogilvie's syndrome with the aim of improving diagnostics.


RESULTS
All had prolonged labour before cesarean section, which was complicated by bleeding. All were treated with syntocinon, a hormone that may influence gastrointestinal motility. All patients developed abdominal meteorism within a few days of operation, which increased despite the passing of flatus and stool. Five cases resulted in caecum perforation before the correct diagnosis and treatment were made. Perforation occurred on days 3-4, day 5, or probably days 8-10 after the operation. One of these patients, who suffered from severe adipositas, died.


CONCLUSIONS
It is very important to make an early diagnosis, as the condition can progress quickly. Diagnosis should be made on the history, clinical assessment, and abdominal X-ray. Intermittent flatus and stool are characteristic of this truly non-obstructive condition and should not therefore delay a diagnostic X-ray.
Schjoldager
B T
BT
Hillerød Sygehus, gynaekologisk-obstetrisk afdeling.
Sørensen
J L
JL
Svaerke
T
T
Berthelsen
J G
JG
D000328:Adult; D002429:Cecal Diseases / Q000175:diagnosis / Q000209:etiology; D002585:Cesarean Section / Q000009:adverse effects*; D003112:Colonic Pseudo-Obstruction / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D004630:Emergencies; D005260:Female; D005414:Flatulence / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology; D007744:Obstetric Labor Complications / Q000175:diagnosis; D006473:Postpartum Hemorrhage / Q000175:diagnosis; D011247:Pregnancy; D014592:Uterine Hemorrhage / Q000175:diagnosis