[Cecum perforation, complication of an acute idiopathic dilatation of the colon, or Ogilvie's syndrome. Practical interest of various pathogenic data. Apropos of one case].

The authors report a new case of caecal perforation complicating acute dilatation of the colon without organic obstruction (Ogilvie's syndrome). They recall the two characteristics of this syndrome : abdominal distension due to colonic ileus, without any organic cause, and the constant coexistence of an associated pathological condition (traumatic, post-operative, infective, cardio-vascular, respiratory or neurological). The major complication is caecal perforation, announced by a clinical and radiological preperforative syndrome. The pathogenesis of Ogilvie's syndrome remains mysterious. Two facts are worth attention : the role of the sympathetic nerve in intestinal paralysis and the direct intervention of an extra-intestinal pathological factor in the onset of this syndrome. Hence two therapeutic consequences : the favourable effect of splanchnic infiltrations on intestinal motility, and the parallel course of acute colonic dilatation and the extra-intestinal disease.