Liu Cherry, Smerin Daniel, Comba Isin, Bhatia Lakhinder
Medicine, University of Central Florida College of Medicine, Orlando, USA.
Internal Medicine, University of Central Florida College of Medicine, Orlando, USA.
Cureus. 2020 May 26;12(5):e8295. doi: 10.7759/cureus.8295.
Ogilvie's syndrome is a rare postoperative condition commonly referred to as a "colonic pseudo-obstruction" due to the absence of mechanical obstruction. It should be a differential for patients over the age of 60 years who present with nausea, vomiting, and colonic dilatations on imaging. Ogilvie's syndrome following a ventriculoperitoneal (VP) shunt placement is an extremely rare entity with only one other adult patient reported in the English literature. In this case report, we explore the diagnosis and management of a 76-year-old patient who presented with abdominal pain and multiple bouts of bilious, non-bloody vomitus two days after a ventriculoperitoneal shunt. The ultimate diagnosis of Ogilvie's syndrome along with imaging and subsequent management is detailed, and diagnosis guidelines and treatment options for Ogilvie's syndrome are analyzed and explained. This case highlights the importance of keeping Ogilvie's syndrome on the list of differentials in a postoperative patient in all abdominal surgeries, even if they are minimally invasive.
奥吉尔维综合征是一种罕见的术后病症,由于不存在机械性梗阻,通常被称为“结肠假性梗阻”。对于60岁以上出现恶心、呕吐且影像学检查显示结肠扩张的患者,应将其列为鉴别诊断对象。脑室腹腔(VP)分流术后发生奥吉尔维综合征是一种极其罕见的情况,英文文献中仅报道过另外一例成年患者。在本病例报告中,我们探讨了一名76岁患者的诊断和治疗情况,该患者在脑室腹腔分流术后两天出现腹痛以及多次胆汁性、非血性呕吐。详细介绍了奥吉尔维综合征的最终诊断以及影像学检查和后续治疗情况,并分析和解释了奥吉尔维综合征的诊断指南和治疗选择。本病例突出了在所有腹部手术的术后患者中,即使是微创手术,将奥吉尔维综合征列入鉴别诊断清单的重要性。