Ogilvie's syndrome treatment.

Introduction: Ogilvie's Syndrome (OS) is a rare condition caused by parasympathetic dysfunction of large bowel characterized by acute and massive colon distension without mechanical obstruction. Rarely this disease has to be treated by the surgeon but operations may be indicated in case of medical treatment failure.

Methods: A retrospective analysis was carried out at the Emergency Surgery DPT of St Orsola-Malpighi University Hospital Bologna Italy. From 1995 to 2002 11 patients were treated for severe OS: they were 8 males and 3 females and the mean age was 68 yrs. All these subjects had large bowel distension with caecum diameter more than 8 cm without any evidence of mechanical obstruction.

Results: In 4 patients (36%) OS was caused by trauma or surgical procedures whereas in 7 cases (64%) was produced by other conditions. Only in 3 cases (27%) conservative treatment was successful; the remaining 8 patients were submitted to surgical therapy. 6 patients were submitted to decompressive caecostomy and in 2 cases a subtotal colectomy was done. Mortality was 36%.

Discussion And Conclusions: Surgical treatment of OS is indicated when there is a conservative treatment failure. The high mortality is related to diagnostic and therapeutic delays, advanced age and comorbidities.