Acute pseudo-obstruction of the colon (Ogilvie's syndrome) following open heart surgery.

The acute pseudo-obstruction of the colon or Ogilvie's syndrome is a rare surgical complication with an unknown pathogenesis. It is characterized by a distention of the large bowel without distal mechanical obstruction and a normal motility of the small bowel. The cause may be a postoperative imbalance between the sympathic and parasympathic innervation of the distal colon. In about one third of the cases a spontaneous perforation of the cecum develops, with a mortality of up to 50 per cent. We report the 5th case after cardiovascular surgery in the literature overall and the first in which conservative therapy successfully prevented perforation and laparotomy. An overview of the etiology, diagnosis, and treatment of this complication is given.