[Acute colonic pseudo-obstruction (Ogilvie's syndrome), a life-threatening complication after total hip replacement].
BACKGROUND
In the literature, an acute colonic pseudo-obstruction (Ogilvie's syndrome) is frequently observed as a complication after hip arthroplasty. It results in a massive colon dilatation without mechanical obstructions and can lead to a life-threatening colon perforation with a high mortality.


METHODS
We report on a 81-year-old male patient who suffered from an acetabular fracture after falling down with a concomitant coxarthrosis at the same hip side. A total hip arthroplasty was performed using a Müller cap. Postoperatively, he developed an acute colonic pseudo-obstruction that was treated conservatively with multiple colonoscopic decompressions. The importance of prompt recognition, careful monitoring and appropriate management to reduce morbidity and mortality are supported by this case.


CONCLUSIONS
Early diagnosis and colonoscopic decompressions play a key role in the therapy for Ogilvie's syndrome. In case of a failure of conservative treatment or peritonism, an early laparotomy and coecostomy are necessary.
Tezval
M
M
Klinik für Unfallchirurgie, Plastische und Wiederherstellungschirurgie der Universitätsklinik Göttingen, Göttingen. mtezval@med.uni-goettingen.de
Sehmisch
S
S
Dumont
C
C
Frosch
K H
KH
Balcarek
P
P
Stürmer
K M
KM
D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D003112:Colonic Pseudo-Obstruction / Q000175:diagnosis / Q000628:therapy*; D003113:Colonoscopy; D003287:Contrast Media / Q000008:administration & dosage; D042241:Early Diagnosis; D004630:Emergencies; D005260:Female; D006801:Humans; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D003287:Contrast Media